Coronavirus disease 2019: changing the future of emergency epistaxis management

J Laryngol Otol. 2021 Aug;135(8):675-679. doi: 10.1017/S0022215121001456. Epub 2021 May 18.

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.

Keywords: Epistaxis; Hemostasis; Patient Reported Outcome Measures.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • Emergency Service, Hospital / statistics & numerical data
  • Epistaxis / therapy*
  • Female
  • Forecasting
  • Hemostatic Techniques
  • Hospital Departments
  • Humans
  • Male
  • Middle Aged
  • Otolaryngology
  • Practice Guidelines as Topic
  • Retrospective Studies
  • United Kingdom / epidemiology