Coronavirus disease 2019: changing the future of emergency epistaxis management. Issue 8 (18th August 2021)

• Record Type: Journal Article
• Authors: Devabalan, Y; Cereceda-Monteoliva, N; Lorenz, H; Magill, J C; Unadkat, S; Ferguson, M; Rennie, C
• Is Part Of: Journal of laryngology & otology. Volume 135:Issue 8(2021)
• Page Start: 675
• Page End: 679
• Publication Date: 2021-08-18
• Subjects: Epistaxis -- Hemostasis -- Patient Reported Outcome Measures; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1017/S0022215121001456
• Languages: English
• ISSNs: 0022-2151

Abstract

Abstract: Background: Acute epistaxis can be a life-threatening airway emergency, requiring in-patient admission. The coronavirus disease 2019 pandemic placed significant strain on hospital resources, and management has shifted towards an out-patient-centred approach. Methods: A five-month single-centre retrospective study was undertaken of all epistaxis patients managed by the ENT department. A pre-coronavirus disease 2019 pandemic group was managed with pre-existing guidelines, compared to new guidelines for the coronavirus disease 2019 pandemic group. A telephone survey was performed on out-patients with non-dissolvable packs to assess patient comfort and satisfaction. Results: A total of 142 patients were seen. The coronavirus disease 2019 pandemic group had significantly more patients aged over 65 years ( p = 0.004), an increased use of absorbable dressings and local haemostatic agents (Nasopore and Surgiflo), and fewer admissions (all p < 0.0005). Rates of re-presentation and morbidity, and length of hospital stay were similar. The telephone survey revealed out-patient management to be efficacious and feasible. Conclusion: The coronavirus disease 2019 pandemic has shifted epistaxis management towards local haemostatic agents and out-patient management; this approach is as safe and effective as previously well-established regimens.