Treatment Plan & Prognosis

Treatment Plan

First aid:

• Pinch soft part of nose
• Lean forward
• Open mouth
• Continue for 10-15 mins

If stable & immunocompetent:

• Naseptin cream QDS 7-10 days
• If neomycin allergy: mupirocin
• Consider cautery if bleeding persists
• Nasal packing if cautery is unavailable

If unstable/severe:

• First aid
• Hospital admission
• ED referral if primary care skills are unavailable

ENT referral indicated:

• Recurrent episodes
• Age <2 years
• Suspected bleeding disorders/haemophilia/leukaemia
• Underlying sinister pathology
• Telangiectasia

Prognosis

Complications:

• Anaemia
• Aspiration
• Hypovolaemia
• Treatment-related: sinusitis, apnoea, pressure necrosis, haematoma, septal perforation (post-cautery)