A) It is more common in hot or cold weather with low humidity
Epistaxis is a common presenting complaint to PEDs. Usually the bleeding is either already controlled by PED arrival or easily controlled with direct pressure. Nose picking and mucosal irritation from rhinitis (especially in low humidity conditions) are common causes. Kiseelbach’s plexus is an anastomosis of 4-5 arteries that supplies the nasal septum and converges in the anteroinferior septum. Juvenile nasopharyngeal angiofibroma can cause severe bleeding and is most commonly seen in adolescent males. Other etiologies include trauma, foreign body, bleeding disorders, and post-operative. If direct pressure is unsuccessful, topical vasoconstrictors and cautery can be tried before resorting to nasal packing. Nasal packing is less optimal in young children due to risk of aspiration and airway obstruction from packing migration. Need for prophylactic antibiotics with nasal packing is controversial and evidence does not support routine use.
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June 13, 2025 at 10:49 pm
A) It is more common in hot or cold weather with low humidity
Epistaxis is a common presenting complaint to PEDs. Usually the bleeding is either already controlled by PED arrival or easily controlled with direct pressure. Nose picking and mucosal irritation from rhinitis (especially in low humidity conditions) are common causes. Kiseelbach’s plexus is an anastomosis of 4-5 arteries that supplies the nasal septum and converges in the anteroinferior septum. Juvenile nasopharyngeal angiofibroma can cause severe bleeding and is most commonly seen in adolescent males. Other etiologies include trauma, foreign body, bleeding disorders, and post-operative. If direct pressure is unsuccessful, topical vasoconstrictors and cautery can be tried before resorting to nasal packing. Nasal packing is less optimal in young children due to risk of aspiration and airway obstruction from packing migration. Need for prophylactic antibiotics with nasal packing is controversial and evidence does not support routine use.