Posterior Epistaxis Nasal Pack

Epistaxis is 1 of the most common emergencies in otolaryngology, with over 60% of the US population reporting having experienced a nosebleed at some point. Nosebleeds can vary in severity, and although the majority of cases are relatively minor, they sometimes can present with severe, even life-threatening, bleeding. Epistaxis is classically categorized as anterior or posterior based on the location of the source. Only 5 to 11% of epistaxis is reported to be posterior. Posterior bleeds typically present briskly, with the location of the culprit vessel often difficult to identify and hemostasis more challenging to achieve. Patients with posterior epistaxis are more likely to be hospitalized and twice as likely to require packing. It is, therefore, important to distinguish between anterior and posterior epistaxis to determine timely and appropriate management. Posterior nasal packing is an effective way of managing patients non-operatively in the emergency department.