Rx Note

Introduction Epistaxis, or nosebleed, is a common presentation that is usually benign, self-limiting and spontaneous. It most commonly occurs in children aged 2-10 years, with peak incidence between 3 and 8 years of age. Aetiology The primary cause of epistaxis is minor trauma. Typical examples include falls, sports injuries or motor vehicle accidents. Environmental factors such as changes in temperature and humidity can lead to mucosal drying and epithelial damage, increasing susceptibility to nosebleeds. Other contributing factors include exposure to chemicals and cigarette smoke. Less common causes include liver disease [causing clotting factor deficiencies (II, VII, IX, X)], anatomic deformity and pathological changes such as benign or malignant tumours. NOTE: Systemic medications (e.g. anticoagulants , antiplatelets and NSAIDs ) and bleeding disorders (e.g. haemophilia ) should also be ruled out. Management For an active nosebleed, Sit upright with the upper body tilted forward ...