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Coronavirus disease 2019: changing the future of emergency epistaxis management

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  18 May 2021

Y Devabalan ,
N Cereceda-Monteoliva ,
H Lorenz ,
J C Magill ,
S Unadkat ,
M Ferguson  and
C Rennie
Y Devabalan*
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
N Cereceda-Monteoliva
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
H Lorenz
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
J C Magill
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
S Unadkat
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
M Ferguson
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
C Rennie
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
*
Author for correspondence: Mr Yadsan Devabalan, Department of Otorhinolaryngology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Rd, Hammersmith, LondonW6 8RF, UK Email: [email protected]
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Abstract

Background

Acute epistaxis can be a life-threatening airway emergency, requiring in-patient admission. The coronavirus disease 2019 pandemic placed significant strain on hospital resources, and management has shifted towards an out-patient-centred approach.

Methods

A five-month single-centre retrospective study was undertaken of all epistaxis patients managed by the ENT department. A pre-coronavirus disease 2019 pandemic group was managed with pre-existing guidelines, compared to new guidelines for the coronavirus disease 2019 pandemic group. A telephone survey was performed on out-patients with non-dissolvable packs to assess patient comfort and satisfaction.

Results

A total of 142 patients were seen. The coronavirus disease 2019 pandemic group had significantly more patients aged over 65 years (p = 0.004), an increased use of absorbable dressings and local haemostatic agents (Nasopore and Surgiflo), and fewer admissions (all p < 0.0005). Rates of re-presentation and morbidity, and length of hospital stay were similar. The telephone survey revealed out-patient management to be efficacious and feasible.

Conclusion

The coronavirus disease 2019 pandemic has shifted epistaxis management towards local haemostatic agents and out-patient management; this approach is as safe and effective as previously well-established regimens.

Keywords

EpistaxisHemostasisPatient Reported Outcome Measures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 8 , August 2021 , pp. 675 - 679
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Mr Y Devabalan takes responsibility for the integrity of the content of the paper

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