Patients can be discharged if there is no further active bleeding, ideally with an advice leaflet.

  • If bleeding continues consider packing:

    • Anterior packing (for anterior bleed):

    • A special nasal sponge or MerocelĀ® tampon is quite easy to insert and fairly comfortable for the patient. As it absorbs blood it swells and the tight fit reduces flow. Lubricate the tampon with K-Y jelly or NaseptinĀ® cream, advance the tampon horizontally all the way into the nose and secure the tampon thread.
      Pack the other side as well. Packs are generally left in place for 24 hours.

    • Otherwise use BIPP or 1cm ribbon gauze impregnated with petroleum jelly (Vaseline) placed carefully and systematically along the floor and then up the vault of the nose. Both ends of the gauze should protrude from the nostril. This may be more effective but less simple and comfortable than the sponge.

    • Tape the string or ribbon to the cheek and apply a nasal bolster.

    • Anterior epistaxis is generally easy to control with local cautery.

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