- Past medical history
- Medications (HTN, anticoagulants, Aspirin, non-steroidal anti- inflammatory drugs)
- Previous episodes of epistaxis
- Duration of bleeding
- Quantity of bleeding
- Bleeding from nasal passage
- Allergic rhinitis
- Viral upper respiratory infection
- Compress nostrils
- Cold packs to bridge of nose
- Apply nasal clip
- Tilt head forward
- Orthostatic blood pressure if needed
- Consider Normal Saline 20 mL/kg IV; max 60 mL/kg or 1,000 mL for pediatric or up to 1,000 mL IV for adult
- Pediatric = 1 day to less than age 12, or less than 55 kg in ages 13-18.
- Use Broselow tape for pediatric drug dosages.
- It is very difficult to quantify the amount of blood loss with epistaxis.
- Bleeding may also be occurring posteriorly. Evaluate for posterior blood loss by examining the posterior pharynx.
- Anticoagulants include Aspirin, Coumadin, non-steroidal anti-inflammatory medications (Ibuprofen), and many over the counter headache relief powders