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Epistaxis

Epistaxis

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Severe or persistent epistaxis no ceasing despite simple or conservative measures
  • Acute nasal fracture with septal haematoma

Immediately contact on-call registrar or service to arrange an immediate ENT assessment (seen within 7 days) for:

  • Nil

To contact relevant service, please see HealthPathways: Acute ENT Assessment

Presenting issues
  • Epistaxis where treatment such as emollients and chemical cautery has been attempted and failed (or not available)
Mandatory referral information (referral will be returned if this information is not included)

History

  • Details of previous treatment and outcome including:
    • Course of systemic and topical medications prescribed
  • Current medication list including any NSAIDS, aspirin or warfarin and anti-hypertensive medication

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)
Highly desirable referral information
  • Coagulopathy/platelet disorder screening results (where available)
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • Epistaxis with no obvious cause
  • Associated change in sense of smell
  • Epiphora
  • Diplopia
  • Unilateral
  • Facial pain
  • Altered sensation in face 
Category 2
Appointment within 90 days
  • No defined category 2 criteria
Category 3
Appointment within 365 days
  • Recurrent epistaxis on a background of nasal trauma
Last reviewed: 02-10-2023
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