Emergency Department care of childhood epistaxis

@article{Bquignon2016EmergencyDC,
  title={Emergency Department care of childhood epistaxis},
  author={{\'E}milie B{\'e}quignon and Natacha Teissier and Annie Gauthier and Lydia Brugel and H{\'e}lo{\"i}se de Kermadec and Andr{\'e} Coste and Virginie Pruli{\`e}re-Escabasse},
  journal={Emergency Medicine Journal},
  year={2016},
  volume={34},
  pages={543 - 548}
}
Objective The aim of this review is to determine an efficient and safe primary strategy care for paediatric epistaxis. Data sources We searched PubMed and Cochrane databases for studies referenced with key words ‘epistaxis AND childhood’. This search yielded 32 research articles about primary care in childhood epistaxis (from 1989 to 2015). Bibliographic references found in these articles were also examined to identify pertinent literature. We compared our results to the specific management of… 
Current Approaches to Epistaxis Treatment in Primary and Secondary Care.
TLDR
The treatment of severe or recurrent epistaxis requires the interdisciplinary collaboration of the primary care physicians, the emergency physician, the practice-based otolaryngologist, and the hospital otolARYngology service.
[Consensus on pediatrics epistaxis: Causes, clinic and treatment].
  • Medicine
    Archivos argentinos de pediatria
  • 2021
TLDR
Most hemorrhages are self-limiting; however, nasal tamponade and cauterization are required in cases of recurrence and/or severity, and endoscopic management, angiography-embolization, and open surgical ligation may be used.
Epistaxis: Outpatient Management.
TLDR
Compared with anterior epistaxis, posterior epistaxis is more likely to require hospitalization and twice as likely to need nasal packing, and patients with posterior packing often require referral to otolaryngology or the emergency department for definitive treatments.
Silver nitrate cautery in the outpatient management of paediatric recurrent idiopathic epistaxis: An institutional review
TLDR
Outpatient silver-nitrate cautery under topical anesthesia is a safe and effective method associated with mild stinging and discomfort in children with recurrent idiopathic epistaxis.
Clinical Practice Guideline: Nosebleed (Epistaxis) Executive Summary
  • D. Tunkel, S. Anne, T. Monjur
  • Medicine
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 2020
TLDR
This guideline addresses the diagnosis, treatment, and prevention of nosebleed and discusses first-line treatments such as nasal compression, application of vasoconstrictors, nasal packing, and nasal cautery.
Clinical Practice Guideline: Nosebleed (Epistaxis)
  • D. Tunkel, S. Anne, T. Monjur
  • Medicine
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 2020
TLDR
This guideline addresses the diagnosis, treatment, and prevention of nosebleed and discusses first-line treatments such as nasal compression, application of vasoconstrictors, nasal packing, and nasal cautery.
Efficacy and Safety of Intranasal Medical Management in Pediatric Patients with Idiopathic Recurrent Epistaxis
TLDR
The use of both an intranasal antimicrobial ointment and a mucosal moisturizing gel as an effective, noninvasive and easily applicable medical treatment option for pediatric patients with idiopathic recurrent epistaxis before more invasive methods of epistaxis control is advised.
Recurrent Bilateral Epistaxis in a 14-Year-Old Boy: a Case Report
TLDR
Physicians should consider JNA in teenage males who present with recurrent, severe epistaxis as well as symptoms of unilateral nasal obstruction, particularly in those with a juvenile nasopharyngeal angiofibroma.
Are laboratory evaluations required in every case admitted to the pediatric emergency department with epistaxis?
TLDR
It was aimed to evaluate the incidence, demographic characteristics, causes of bleeding and treatment methods of patients who presented to the pediatric emergency department (PED) with epistaxis, and to determine in which cases a laboratory test should be used.
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References

SHOWING 1-10 OF 47 REFERENCES
An update on management of pediatric epistaxis.
Controversies in the specialist management of adult epistaxis: 
an evidence‐based review
  • P. Spielmann, M. L. Barnes, P. White
  • Medicine
    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
  • 2012
TLDR
The purpose of this paper is to review the literature concerning the management of epistaxis and to make evidence-based recommendations for treatment.
Interventions for recurrent idiopathic epistaxis (nosebleeds) in children.
TLDR
High quality randomised controlled trials comparing interventions either with placebo or no treatment, and with a follow-up period of at least a year, are needed to assess the relative merits of the various treatments currently in use.
Interventions for recurrent idiopathic epistaxis (nosebleeds) in children.
TLDR
The optimal management of children with recurrent idiopathic epistaxis is unknown, however if silver nitrate nasal cautery is undertaken 75% is preferable to 95% as it is more effective in the short term and causes less pain.
On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions.
TLDR
Using the treatment options, anterior epistaxis can be cured reliably by cauterisation and surgical therapies in posterior bleedings are able to successfully salvage failed packing therapies.
A comparative study of propranolol versus silver nitrate cautery in the treatment of recurrent primary epistaxis in children
TLDR
Treatment of primary epistaxis with propranolol orSilver nitrate cautery showed equal rates of recurrence, and local nasal pain was slightly more among silver nitrate cauterization treated group.
Epistaxis: an update on current management
TLDR
Recent evidence suggests that this, combined with the use of stepwise management plans, should limit patient complications and the need for admission.
Epistaxis: prospective evaluation of bleeding site and its impact on patient outcome
TLDR
Most patients with epistaxis can be controlled with nasal cauterisation, however, patients with posterior epistaxis are more likely to need hospital admission, are twice as likely to require nasal packing, and stay in hospital longer.
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