Epistaxis: The Daily PANCE Blueprint

The answer is Compressive therapy

Epistaxis, or nosebleeds, are a common complaint, and the causes range from infectious to traumatic, coagulopathic, or medication-related. Most nosebleeds are anterior and arise from the Kiesselbach plexus, making them easier to manage. The first-line management for anterior epistaxis is compressive therapy, where the soft part of the nostrils is pinched for 5-10 minutes while leaning slightly forward to prevent swallowing blood. In cases where compressive therapy fails, adjuncts like oxymetazoline spray or silver nitrate may be used. Posterior nosebleeds, which are more serious and arise from the sphenopalatine artery, often require hospitalization and more invasive treatments such as nasal packing or a balloon catheter.

Incorrect Answers:

• Oxymetazoline spray: Can be used after compressive therapy to induce vasoconstriction, but it is not the first-line option.
• Silver nitrate: This is used to cauterize bleeding vessels but is considered after initial compressive therapy fails.
• Nasal packing: Reserved for more severe or posterior bleeds that do not respond to simpler measures.
• Balloon catheter: Typically used for posterior epistaxis that is refractory to nasal packing or compressive measures.