Clinical Case Database / Category: Clinical Care

Acute assessment and management of epistaxis

Publication details

James Thambyrajah (FY2), Annabelle C. Leong (SpR), David Bowdler (Consultant)
Foundation Years Journal, volume 4, issue 7, p.10 (123Doc Education, London, July 2010)


Epistaxis is the most common ENT emergency, affecting 60% of the population in their lifetime, with 6% presenting to hospital1. It often presents to other specialties, including A&E, medical and paediatric disciplines. The objective of the article is to guide foundation trainees in the acute assessment and management of epistaxis.

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James Thambyrajah (FY2)

Dept of Otolaryngology
University Hospital Lewisham
Lewisham High Street
London SE13 6LH

Annabelle C. Leong (SpR)

Dept of Otolaryngology
University Hospital Lewisham
Lewisham High Street
London SE13 6LH

David Bowdler (Consultant)

Dept of Otolaryngology
University Hospital Lewisham
Lewisham High Street
London SE13 6LH


1. Duvvi S, Khattab A, Khalil HS et al. Short falls in epistaxis management. A Nationwide Survey in the UK. Clin Otol 2006; 31: 560-561.
2. Thornton MA, Mahesh BN, Lang J. Posterior epistaxis: Identification of common bleeding sites. Laryngoscope 2005; 115: 588-590
3. Schlosser RJ. Epistaxis. NEJM 2009; 360: 784-789.
4. Choudhury N, Sharp HR, Mir N et al. Epistaxis and oral anticoagulant therapy. Rhinology 2004; 92-97.
5. Murphy P, Christodolou C , Yatigammana N et al. The Influence of medical audit on the management of epistaxis in 3 district general hospitals: J Laryngol Otol 1994; 108: 38-41
6. Nouraei SA, Maani T, Hajioff D et al. Outcome of endoscopic sphenopalatine artery occlusion for intractable epistaxis: a 10-year experience. Laryngoscope 2007; 117: 1452-6.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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