References

Key articles

Womack JP, Kropa J, Jimenez Stabile M. Epistaxis: outpatient management. Am Fam Physician. 2018 Aug 15;98(4):240-5.Full text  Abstract

Tunkel DE, Anne S, Payne SC, et al. Clinical practice guideline: nosebleed (epistaxis). Otolaryngol Head Neck Surg. 2020 Jan;162(1 suppl):S1-38.Full text  Abstract

Seikaly H. Epistaxis. N Engl J Med. 2021 Mar 11;384(10):944-51.

Reference articles

1. Santos P, Lepore M. Epistaxis. In: Bailey B, Healy G, Johnson J, et al., eds. Head & neck surgery-otolaryngology. Philadelphia: Lippincott, Williams & Wilkins; 2001:415-28.

2. Massick D, Tobin E. Epistaxis. In: Cummings C, Flint P, Harker L, et al., eds. Otolaryngology-head and neck surgery. Philadelphia: Elsevier Mosby; 2005:942-61.

3. Womack JP, Kropa J, Jimenez Stabile M. Epistaxis: outpatient management. Am Fam Physician. 2018 Aug 15;98(4):240-5.Full text  Abstract

4. Yau S. An update on epistaxis. Aust Fam Physician. 2015 Sep;44(9):653-6.Full text  Abstract

5. Tunkel DE, Anne S, Payne SC, et al. Clinical practice guideline: nosebleed (epistaxis). Otolaryngol Head Neck Surg. 2020 Jan;162(1 suppl):S1-38.Full text  Abstract

6. Viehweg TL, Roberson JB, Hudson JW. Epistaxis: diagnosis and treatment. J Oral Maxillofac Surg. 2006 Mar;64(3):511-8. Abstract

7. Tan L, Calhoun K. Epistaxis. Med Clin North Am. 1999 Jan;83(1):43-56. Abstract

8. Perretta L, Denslow B, Brown C. Emergency evaluation and management of epistaxis. Emerg Med Clin North Am. 1987 May;5(2):265-77. Abstract

9. Pond F, Sizeland A. Epistaxis: strategies for management. Aust Fam Physician. 2000 Oct;29(10):933-8. Abstract

10. Seikaly H. Epistaxis. N Engl J Med. 2021 Mar 11;384(10):944-51.

11. Tawagi K, Akaraz-Avedissian R, Burman-Solovyeva I. Recurrent epistaxis leading to diagnosis of primary sinonasal melanoma. BMJ Case Rep. 2018 Feb 16;2018:bcr2017219832.Full text  Abstract

12. Davis KR. Embolization of epistaxis and juvenile nasopharyngeal angiofibromas. AJR Am J Roentgenol. 1987 Jan;148(1):209-18.Full text  Abstract

13. Pryor SG, Moore EJ, Kasperbauer JL. Endoscopic versus traditional approaches for excision of juvenile nasopharyngeal angiofibroma. Laryngoscope. 2005 Jul;115(7):1201-7. Abstract

14. Viducich R, Blanda MP, Gerson LW. Posterior epistaxis: clinical features and acute complications. Ann Emerg Med. 1995 May;25(5):592-6. Abstract

15. Herkner H, Havel C, Müllner M, et al. Active epistaxis at ED presentation is associated with arterial hypertension. Am J Emerg Med. 2002 Mar;20(2):92-5. Abstract

16. Min HJ, Kang H, Choi GJ, et al. Association between hypertension and epistaxis: systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2017 Dec;157(6):921-7. Abstract

17. Byun H, Chung JH, Lee SH, et al. Association of hypertension with the risk and severity of epistaxis. JAMA Otolaryngol Head Neck Surg. 2020 Sep 10;147(1):1-7. Abstract

18. Gregory I, Grewal A. Cochrane corner: Intranasal corticosteroids for non-allergic rhinitis. Clin Exp Allergy. 2022 Jul;52(7):836-8.Full text

19. Sanders YV, Fijnvandraat K, Boender J, et al. Bleeding spectrum in children with moderate or severe von Willebrand disease: relevance of pediatric-specific bleeding. Am J Hematol. 2015 Dec;90(12):1142-8.Full text  Abstract

20. Rosenberg T, Fialla AD, Kjeldsen J, et al. Does severe bleeding in HHT patients respond to intravenous bevacizumab? review of the literature and case series. Rhinology. 2019 Aug 1;57(4):242-51. Abstract

21. Soyka MB, Rufibach K, Huber A, et al. Is severe epistaxis associated with acetylsalicylic acid intake? Laryngoscope. 2010 Jan;120(1):200-7.Full text  Abstract

22. Reibez EE, Bryan DJ, Ehrlichman RJ, et al. Surgical management of life threatening epistaxis in Osler-Weber-Rendu disease. Ann Plast Surg. 1995 Aug;35(2):208-13. Abstract

23. Lund VJ, Howard DJ. A treatment algorithm for the management of epistaxis in hereditary hemorrhagic telangiectasias. Am J Rhinol. 1999 Jul-Aug;13(4):319-22. Abstract

24. Potentas-Policewicz M, Fijolek J. Granulomatosis with polyangiitis: clinical characteristics and updates in diagnosis. Front Med (Lausanne). 2024;11:1369233.Full text  Abstract

25. Cereceda-Monteoliva N, Rouhani MJ, Maughan EF, et al. Sarcoidosis of the ear, nose and throat: a review of the literature. Clin Otolaryngol. 2021 Sep;46(5):935-40.Full text  Abstract

26. Javed F, Golagani A, Sharp H, et al. Potential effects of herbal medicines and nutritional supplements on coagulation in ENT practice. J Laryngol Otol. 2008 Feb;122(2):116-9. Abstract

27. Kucik CJ, Clenney T. Management of epistaxis. Am Fam Physician. 2005 Jan 15;71(2):305-11.Full text  Abstract

28. Neutze D, Roque J. Clinical evaluation of bleeding and bruising in primary care. Am Fam Physician. 2016 Feb 15;93(4):279-86.Full text  Abstract

29. American College of Radiology. ACR appropriateness criteria: imaging of facial trauma following primary survey. 2021 [internet publication].Full text

30. Reyre A, Michel J, Santini L, et al. Epistaxis: The role of arterial embolization. Diagn Interv Imaging. 2015 Jul-Aug;96(7-8):757-73.Full text  Abstract

31. Simundic AM, Bölenius K, Cadamuro J, et al. Joint EFLM-COLABIOCLI recommendation for venous blood sampling. Clin Chem Lab Med. 2018;56(12):2015-38. Abstract

32. ENT UK. Nose bleed (epistaxis) - Global ENT guideline. Mar 2023 [internet publication].Full text

33. Birmingham AR, Mah ND, Ran R, et al. Topical tranexamic acid for the treatment of acute epistaxis in the emergency department. Am J Emerg Med. 2018 Jul;36(7):1242-5. Abstract

34. Whitworth K, Johnson J, Wisniewski S, et al. Comparative effectiveness of topically administered tranexamic acid versus topical oxymetazoline spray for achieving hemostasis in epistaxis. J Emerg Med. 2020 Feb;58(2):211-6. Abstract

35. Janapala RN, Tran QK, Patel J, et al. Efficacy of topical tranexamic acid in epistaxis: a systematic review and meta-analysis. Am J Emerg Med. 2022 Jan;51:169-75. Abstract

36. Hosseinialhashemi M, Jahangiri R, Faramarzi A, et al. Intranasal topical application of tranexamic acid in atraumatic anterior epistaxis: a double-blind randomized clinical trial. Ann Emerg Med. 2022 Sep;80(3):182-8.Full text  Abstract

37. Bridwell RE, April MD, Long B. Does oral or topical tranexamic acid control bleeding from epistaxis? Ann Emerg Med. 2019 Aug;74(2):300-2.Full text  Abstract

38. Bequignon E, Vérillaud B, Robard L, et al. Guidelines of the French Society of Otorhinolaryngology (SFORL). First-line treatment of epistaxis in adults. Eur Ann Otorhinolaryngol Head Neck Dis. 2017 May;134(3):185-9.Full text  Abstract

39. Richardson C, Abrol A, Cabrera CI, et al. The power of a checklist: decrease in emergency department epistaxis transfers after clinical care pathway implementation. Am J Otolaryngol. 2021 Jul-Aug;42(4):102941. Abstract

40. Milinis K, Swords C, Hardman JC, et al. Dissolvable intranasal haemostatic agents for acute epistaxis: a systematic review and meta-analysis. Clin Otolaryngol. 2021 May;46(3):485-93. Abstract

41. Dehn R, Asprey D. Essential clinical procedures. 4th ed. Chapter 10: Epistaxis and nasal foreign body removal. Philadelphia, PA: Elsevier Saunders.

42. Kucik CJ, Clenney T. Management of epistaxis. Am Fam Physician. 2005;71(2):305-11.Full text  Abstract

43. Biggs TC, Nightingale K, Patel NN, et al. Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs? Ann R Coll Surg Engl. 2013 Jan;95(1):40-2.Full text  Abstract

44. Randall DA. Epistaxis packing. Practical pointers for nosebleed control. Postgrad Med. 2006 Jun-Jul;119(1):77-82. Abstract

45. National ENT Trainee Research Network. The British Rhinological Society multidisciplinary consensus recommendations on the hospital management of epistaxis. J Laryngol Otol. 2017 Dec;131(12):1142-56. Abstract

46. Beck R, Sorge M, Schneider A, et al. Current approaches to epistaxis treatment in primary and secondary care. Dtsch Arztebl Int. 2018 Jan 8;115(1-02):12-22.Full text  Abstract

47. Barr G. Silver nitrate cautery and epistaxis. Arch Emerg Med. 1989 Sep;6(3):233.Full text  Abstract

48. Upile T, Jerjes W, Sipaul F, et al. A change in UK epistaxis management. Eur Arch Otorhinolaryngol. 2008 Nov;265(11):1349-54. Abstract

49. Tran QK, Barnett J, O'Connell F, et al. Nasal packing in the emergency department: a practical review for emergency providers. Open Access Emerg Med. 2021;13:527-33.Full text  Abstract

50. Anon JB, Jacobs MR, Poole MD, et al. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg. 2004 Jan;130(1 suppl):1-45.Full text  Abstract

51. Kemppainen T, Kokki H, Tuomilehto H, et al. Acetaminophen is highly effective in pain treatment after endoscopic sinus surgery. Laryngoscope. 2006 Dec;116(12):2125-8. Abstract

52. Morganstein S. Surgical management of epistaxis. Arch Otolaryngol Head Neck Surg. 1987 Dec;113(12):1338. Abstract

53. Moshaver A, Harris JR, Liu R, et al. Early operative intervention versus conventional treatment in epistaxis: randomized prospective trial. J Otolaryngol. 2004 Jun;33(3):185-8. Abstract

54. Durr DG. Endoscopic electrosurgical management of posterior epistaxis: shifting paradigm. J Otolaryngol. 2004 Aug;33(4):211-6. Abstract

55. Stankiewicz J. Nasal endoscopy and control of epistaxis. Curr Opin Otolaryngol Head Neck Surg. 2004 Feb;12(1):43-5. Abstract

56. Kumar S, Shetty A, Rockey J, et al. Contemporary surgical treatment of epistaxis: what is the evidence for sphenopalatine artery ligation? Clin Otolaryngol Allied Sci. 2003 Aug;28(4):360-3. Abstract

57. Strong E, Bell D, Johnson L, et al. Intractable epistaxis: transantral ligation vs embolization: efficacy review and cost analysis. Otolaryngol Head Neck Surg. 1995 Dec;113(6):674-8. Abstract

58. Christensen N, Smith D, Barnwell S, et al. Arterial embolization in the management of posterior epistaxis. Otolaryngol Head Neck Surg. 2005 Nov;133(5):748-53. Abstract

59. Leung RM, Smith TL, Rudmik L. Developing a laddered algorithm for the management of intractable epistaxis: a risk analysis. JAMA Otolaryngol Head Neck Surg. 2015 May 1;141(5):405-9.Full text  Abstract

60. Douglas R, Wormald PJ. Update on epistaxis. Curr Opin Otolaryngol Head Neck Surg. 2007 Jun;15(3):180-3. Abstract

61. Scaramuzzi N, Walsh R, Brennan P, et al. Treatment of intractable epistaxis using arterial embolization. Clin Otolaryngol Allied Sci. 2001 Aug;26(4):307-9. Abstract

62. Webster J, Osborne S, Rickard CM, et al. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2019 Jan 23;(1):CD007798.Full text  Abstract

63. Qureishi A, Burton MJ. Interventions for recurrent idiopathic epistaxis (nosebleeds) in children. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD004461.Full text  Abstract

64. Loughran S, Spinou E, Clement E, et al. A prospective, single blind, randomised controlled trial of petroleum jelly/Vaseline for recurrent paediatric epistaxis. Clin Otolaryngol Allied Sci. 2004 Jun;29(3):266-9. Abstract

65. Calder N, Kang S, Fraser L, et al. A double-blind randomized controlled trial of management of recurrent nosebleeds in children. Otolaryngol Head Neck Surg. 2009 May;140(5):670-4. Abstract

66. Zohar Y, Straus M. Epistaxis due to hereditary hemorrhagic telangiectasia. Laryngoscope. 1995 Apr;105(4 Pt 1):445-6. Abstract

67. Ruddy J, Proops DW, Pearman K, et al. Management of epistaxis in children. Int J Paediatr Otorhinolaryngol. 1991 Apr;21(2):139-42. Abstract

68. Al-Samkari H, Kasthuri RS, Iyer VN, et al. Pomalidomide for epistaxis in hereditary hemorrhagic telangiectasia. N Engl J Med. 2024 Sep 19;391(11):1015-27.Full text  Abstract

69. Royal Children’s Hospital Melbourne. Clinical guideline: epistaxis. 2019 [internet publication].Full text

70. ENT UK. Guideline for management of idiopathic epistaxis in adults. Mar 2019 [internet publication].Full text

71. International HHT Guidelines. ​Epistaxis (nosebleed) management [internet publication].Full text

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