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Is the nasal tampon a suitable treatment for epistaxis in Accident & Emergency? A comparison of outcomes for ENT and A&E packed patients

Published online by Cambridge University Press:  08 March 2006

Andrew S. Evans
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Western General Hospital,Edinburgh.
David Young
Affiliation:
Research and Development Office, Royal Hospital for Sick Children, Yorkhill,Glasgow and Department of Statistics and Modelling Science,University of Strathclyde, Glasgow.
Richard Adamson
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Western General Hospital,Edinburgh.

Abstract

This retrospective observational study aimed to establish the outcome for patients packed with a nasal tampon as first-line therapy for epistaxis in Accident & Emergency compared to those packed by ENT. During our study period, 189 admissions were treated with a nasal tampon as first-line therapy; 89 were inserted by ENT and 100 by A&E. A significantly higher number of patients packed by A&E required further treatment to control bleeding (p = 0.004; 95 per cent CI 7–34) than those in the group packed by ENT. A significantly greater proportion from the A&E group required additional cautery alone to control bleeding (p = 0.005; 95 per cent CI 5–30). We suggest that this may be due to inadequate initial assessment and inappropriate first-line therapy in the A&E department. It is recommended that ENT review patients prior to packing, in order to reduce the morbidity associated with multiple treatments.

Type
Research Article
Copyright
© Royal Society of Medicine Press Limited 2004

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