Is the nasal tampon a suitable treatment for epistaxis in Accident & Emergency? A comparison of outcomes for ENT and A&E packed patients.
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.
Evans
Andrew S
AS
Department of Otolaryngology and Head and Neck Surgery, Western General Hospital, Edinburgh. drase25@hotmaill.com
Young
David
D
Adamson
Richard
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004630:Emergencies; D004636:Emergency Service, Hospital; D004844:Epistaxis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods; D012189:Retrospective Studies; D012606:Scotland; D013630:Tampons, Surgical; D016896:Treatment Outcome