ENTPending review

Epistaxis

Bleeding from the nasal mucosa, most often from the densely vascular anterior septum, where management escalates in a stepwise fashion from simple first aid to cautery, packing and, rarely, surgery according to where the bleeding source sits and how well it is controlled.

First principles

Most nosebleeds come from one small, predictable, highly vascular area

The anterior nasal septum contains Little's area (Kiesselbach's plexus), a confluence of several arterial supplies (from the internal and external carotid systems) lying just under a thin, exposed mucosa. Because this mucosa is thin, superficial and constantly exposed to airflow, drying and minor trauma (nose-picking, forceful blowing), it is by far the most common site of bleeding, especially in children and young adults. Anterior bleeds are usually visible on examination and are amenable to direct pressure and cautery because the bleeding point is accessible.

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Educational content pending clinical review. Not medical advice.