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Initial assessment in the management of adult epistaxis: systematic review.

Abstract The initial assessment of epistaxis patients commonly includes: first aid measures, observations, focused history taking, and clinical examinations and investigations. This systematic review aimed to identify evidence that informs how the initial assessment of these patients should be conducted.
PMID
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Authors

Mayor MeshTerms
Keywords

Cardiovascular Diseases

Comorbidity

Epistaxis

First Aid

Hypertension

Risk Factors

Therapy

Journal Title the journal of laryngology and otology
Publication Year Start




PMID- 29280694
OWN - NLM
STAT- MEDLINE
DCOM- 20180102
LR  - 20180102
IS  - 1748-5460 (Electronic)
IS  - 0022-2151 (Linking)
VI  - 131
IP  - 12
DP  - 2017 Dec
TI  - Initial assessment in the management of adult epistaxis: systematic review.
PG  - 1035-1055
LID - 10.1017/S0022215117002031 [doi]
AB  - BACKGROUND: The initial assessment of epistaxis patients commonly includes: first
      aid measures, observations, focused history taking, and clinical examinations and
      investigations. This systematic review aimed to identify evidence that informs
      how the initial assessment of these patients should be conducted. METHOD: A
      systematic review of the literature was performed using a standardised
      methodology and search strategy. RESULTS: Seventeen articles were included.
      Factors identified were: co-morbidity, intrinsic patient factors, coagulation
      screening and ice pack use. Hypertension and anticoagulant use were demonstrated 
      to adversely affect outcomes. Coagulation screening is useful in patients on
      anticoagulant medication. Four studies could not be accessed. Retrospective
      methodology and insufficient statistical analysis limit several studies.
      CONCLUSION: Sustained ambulatory hypertension, anticoagulant therapy and
      posterior bleeding may be associated with recurrent epistaxis, and should be
      recorded. Oral ice pack use may decrease severity and can be considered as first 
      aid. Coagulation studies are appropriate for patients with a history of
      anticoagulant use or bleeding diatheses.
FAU - Khan, M
AU  - Khan M
AD  - Department of Otolaryngology,Central Manchester University Hospitals,UK.
FAU - Conroy, K
AU  - Conroy K
AD  - Department of Otolaryngology,University Hospitals of South Manchester,UK.
FAU - Ubayasiri, K
AU  - Ubayasiri K
AD  - Queen's Medical Centre,Nottingham,UK.
FAU - Constable, J
AU  - Constable J
AD  - Queen's Medical Centre,Nottingham,UK.
FAU - Smith, M E
AU  - Smith ME
AD  - Department of Otolaryngology,Addenbrooke's Hospital,Cambridge,UK.
FAU - Williams, R J
AU  - Williams RJ
AD  - Institute of Naval Medicine,Gosport,UK.
FAU - Kuhn, I
AU  - Kuhn I
AD  - University of Cambridge School of Clinical Medicine,UK.
FAU - Smith, M
AU  - Smith M
AD  - Exeter Health Library,Peninsula Medical School,UK.
FAU - Philpott, C
AU  - Philpott C
AD  - Norwich Medical School,University of East Anglia,UK.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Laryngol Otol
JT  - The Journal of laryngology and otology
JID - 8706896
SB  - AIM
SB  - IM
MH  - Adult
MH  - Comorbidity
MH  - Diagnostic Tests, Routine
MH  - Epistaxis/*etiology/*therapy
MH  - Evidence-Based Medicine
MH  - First Aid
MH  - Humans
MH  - Injury Severity Score
MH  - Medical History Taking
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cardiovascular Diseases
OT  - Comorbidity
OT  - Epistaxis
OT  - First Aid
OT  - Hypertension
OT  - Risk Factors
OT  - Therapy
EDAT- 2017/12/28 06:00
MHDA- 2017/12/28 06:00
CRDT- 2017/12/28 06:00
PHST- 2017/12/28 06:00 [entrez]
PHST- 2017/12/28 06:00 [pubmed]
PHST- 2017/12/28 06:00 [medline]
AID - S0022215117002031 [pii]
AID - 10.1017/S0022215117002031 [doi]
PST - ppublish
SO  - J Laryngol Otol. 2017 Dec;131(12):1035-1055. doi: 10.1017/S0022215117002031.