ENT

Epistaxis

Nasal bleeding is usually anterior and responds to correct pressure, but heavy, posterior or recurrent bleeding needs structured assessment, packing and ENT escalation.

Definition

Epistaxis is bleeding from the nasal mucosa, most commonly the anterior septum at Little's area. It ranges from a minor self-limiting bleed to a severe posterior haemorrhage requiring resuscitation and ENT intervention.

First principles

Most nosebleeds are anterior and accessible

Little's area (Kiesselbach's plexus) on the anterior nasal septum is a superficial confluence of vessels exposed to airflow, dryness and minor trauma. Anterior bleeding is often visible and can be controlled with correct compression or targeted cautery.

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