Nasal Packing in the Emergency Department: A Practical Review for Emergency Providers

Quincy K Tran; Jeremy Barnett; Francis O'Connell; Brian D'Anza; Ali Pourmand

doi:10.2147/OAEM.S247017

Nasal Packing in the Emergency Department: A Practical Review for Emergency Providers

Open Access Emerg Med. 2021 Dec 2:13:527-533. doi: 10.2147/OAEM.S247017. eCollection 2021.

Authors

Quincy K Tran^{1

2}, Jeremy Barnett³, Francis O'Connell³, Brian D'Anza⁴, Ali Pourmand³

Affiliations

¹ Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
² Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
³ Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
⁴ Department of Otolaryngology - Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA.

Abstract

We performed a narrative review of epistaxis management in the emergency department. First, we examined the pathophysiology, the current types of treatment that are available to emergency clinicians. When nasal packing is indicated, we examined the efficacy of nasal packing in addition to other topical treatment such as tranexamic acid and the evidence of prophylactic antibiotics. We detailed current studies involving tranexamic acid and prophylactic antibiotics for nasal packing. Finally, we introduced an epistaxis clinical care pathway, based on current evidence, to aid emergency clinicians with their clinical decision-making processes.

Keywords: clinical care pathway; epistaxis; nasal packing; tranexamic acid.

Publication types

Review

Grants and funding

The authors did not receive any source of funding, internal or commercial, for the work of this manuscript.