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Elsayed Elboraei YA, Alanazi MM, Fawzan Almesned B, Alanazi WK, Almutairi DN, Alanazi ILN, Alanazi GKH, Fawzy MS. Awareness of First Aid Management of Epistaxis in Children Among Parents in Arar, Saudi Arabia. Cureus 2023; 15:e49557. [PMID: 38156178 PMCID: PMC10753863 DOI: 10.7759/cureus.49557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Epistaxis is a relatively common condition, particularly among children, necessitating that parents be well informed about its effective management. OBJECTIVES This study aims to explore the current level of awareness among parents in the Arar region, Saudi Arabia, regarding the first aid management of epistaxis and to highlight the importance of education in empowering parents to handle such situations. METHODS A cross-sectional study was conducted using a survey distributed among the Arar population (aged >18 years) who had at least one child and were willing to participate. Data were collected between mid-July and the end of September 2023 using a self-administered questionnaire, which included a consent form, sociodemographic and background items, and epistaxis knowledge-related questions. RESULTS A total of 342 participants (27.8% males) completed the questionnaire. It was observed that 47.4% of the participants' children had experienced epistaxis. Only around half of them (n=84; 51.9%) had received first aid management for epistaxis, and only 40.4% of the parents correctly identified all the necessary steps for managing it through first aid. There was inadequate knowledge regarding the causes/risk factors and appropriate first aid techniques for epistaxis. Certain sociodemographic factors were significantly associated with better knowledge of first aid management of epistaxis, such as female gender (p = 0.003), older participants (p = 0.002), and a higher educational level (p = 0.001). CONCLUSION The study found low awareness of first aid management of epistaxis among parents residing in Arar, Saudi Arabia. Factors related to the demographic characteristics of the study participants were associated with this level of knowledge. These findings emphasize the need to improve awareness about first aid management of epistaxis, particularly among younger individuals, males, and those with limited education. Effective interventions should be developed to enhance first aid training, considering the specific risk factors associated with epistaxis.
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Affiliation(s)
| | | | | | | | | | | | | | - Manal S Fawzy
- Biochemistry, Faculty of Medicine, Northern Border University, Arar, SAU
- Medical Research Unit, Faculty of Medicine, Northern Border University, Arar, SAU
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Aremu SK. Knowledge and awareness of aetiological and risk factors as determinants of health-seeking pattern of parents of children with epistaxis in a tertiary health institution: A 7-year prospective study. Afr J Paediatr Surg 2023; 20:211-217. [PMID: 37470558 PMCID: PMC10450115 DOI: 10.4103/ajps.ajps_3_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 05/01/2022] [Accepted: 06/30/2022] [Indexed: 01/22/2023] Open
Abstract
Aim This prospective study aimed to assess the knowledge and awareness of aetiological and risk factors as determinants of the health-seeking pattern of parents of children with epistaxis in a tertiary health institution. Materials and Methods This was a 7-year cross-sectional prospective study where copies of the questionnaire were distributed to consenting parents whose children presented to our institution with epistaxis between January 2015 and December 2021. A total of 570 parents were enrolled in the study in the research time period. Results Out of 570 patients, majority (39%) were aged between 11 and 15 years, followed by 35% aged between 6 and 10 years, 17% aged between 1 and 5 years and 11% aged between 16 and 18 years. Three hundred and eighty (66.67%) were male and 190 (33.33%) were female. Two hundred and ninety-five (51.75%) patients had primary education, followed by 189 (33.16%) patients with secondary education and 86 (15.09%) patients with preschool education. Three hundred and seventy-three (65.44%) patients had anterior bleeding and 107 (18.77%) patients had posterior bleeding while 90 (15.79%) patients had both anterior and posterior bleeding. The majority of the parents, 399 (70%), were aware about the epistaxis while 171 (30%) parents were unaware about the epistaxis. Conclusion A significant number of parents are unaware of the epistaxis and also unaware of the various aetiological and risk factors of the epistaxis and these issues need a more nuanced analysis in light of Africa's rich cultural diversity.
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Affiliation(s)
- Shuaib Kayode Aremu
- Department of ENT, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Ekiti, Nigeria
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Ruhela S, Mittal HK, Bist SS, Luthra M, Kumar L, Agarwal VK. Clinico-Etiological Evaluation of Epistaxis. Indian J Otolaryngol Head Neck Surg 2023; 75:828-835. [PMID: 37206732 PMCID: PMC10188701 DOI: 10.1007/s12070-022-03458-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Epistaxis or bleeding from nose, a commonly confronted condition in the department of otorhinolaryngology can be a disquietening experience and sometimes a life threatening emergency for the patient. The aim of this study is to study the clinical profile and aetiology in epistaxis patients. An observational prospective study carried out over a period of 12 months in the Department of Otorhinolaryngology, Head and Neck Surgery, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand. A total of 104 patients of all age groups and gender presenting with epistaxis were included in the study. Males formed majority of the patients (68.27%) as compared to female patients (31.73%). Most of the patients were in the age group of 51-70 years with majority being farmers (30.77%). The finding of variation with age was statistically significant (p < 0.05) with most patients in the age group of 51-60 years presenting in winter season. Local causes were observed to be more common (50.96%) among which trauma was the predominant cause (23.08%). Systemic causes formed 37.58% of cases, out of which hypertension was the commonest cause. In our study, non-surgical measures were most commonly employed treatment modality (85.58%) among which medical management was done in most patients. Trauma and hypertension contributed to the majority of patients presenting with epistaxis in our study with cold, dry winter months associated with increased incidence of epistaxis.
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Affiliation(s)
- Shivam Ruhela
- Department of Otorhinolaryngology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand 248016 India
| | - Himanshu Kumar Mittal
- Department of Otorhinolaryngology, Government Medical College and Hospital, Sec-32, Chandigarh, India
| | - S. S. Bist
- Department of Otorhinolaryngology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand 248016 India
| | - Mahima Luthra
- Department of Otorhinolaryngology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand 248016 India
| | - Lovneesh Kumar
- Department of Otorhinolaryngology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand 248016 India
| | - Vinish Kumar Agarwal
- Department of Otorhinolaryngology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand 248016 India
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Jamshaid S, Banhidy N, Ghedia R, Seymour K. Where should epistaxis education be focused? A comparative study between the public and healthcare workers on knowledge of first aid management methods of epistaxis. J Laryngol Otol 2023; 137:408-412. [PMID: 35606896 DOI: 10.1017/s0022215122001098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Epistaxis can be life-threatening. Simple first aid management can stem bleeding. This study compared knowledge of first aid management methods of epistaxis between the general public and healthcare workers. METHOD A cross-sectional study of 100 healthcare workers and 103 adult members of the public was conducted at a large London teaching hospital. Respondents completed a survey assessing knowledge on nasal pinching site, head tilt and appropriate adjunct treatment use for first aid management of epistaxis. RESULTS Twenty-four per cent and 68 per cent of healthcare workers compared with 25.2 per cent and 37.9 per cent of the public answered correctly on nasal pinching position and head tilt position, respectively, with a statistical difference for head tilt position. Two per cent, 2 per cent and 24 per cent of healthcare workers mentioned ice use on the nose, ice use in the mouth or ice use but not site, respectively, compared with 0 per cent, 0 per cent and 4.9 per cent of the public, with a statistical difference for ice without site. CONCLUSION Healthcare workers and the public lack knowledge on first aid management of epistaxis. Improved education on first aid management is required, targeting healthcare workers and the public.
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Affiliation(s)
- S Jamshaid
- Department of ENT and Head-Neck Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - N Banhidy
- Department of ENT and Head-Neck Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - R Ghedia
- Department of ENT and Head-Neck Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - K Seymour
- Department of ENT and Head-Neck Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
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Hoffman H, Ashok Kumar A, Raventhiranathan N, Masoud HE, Gould GC. Endovascular embolization for the treatment of epistaxis: Systematic review and meta-analysis. Interv Neuroradiol 2023; 29:172-182. [PMID: 35238666 PMCID: PMC10152829 DOI: 10.1177/15910199221081715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/06/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Endovascular embolization (EE) is a treatment option for epistaxis refractory to first-line interventions. Data regarding embolization is limited to small case series and a meta-analysis has not been performed. METHODS PubMed, Scopus, and EMBASE were used to identify studies that reported outcomes for at least 10 patients undergoing EE for epistaxis. Outcomes included procedural success, rebleeding, and complications. Pooled rates for each outcome were obtained with random effects models. RESULTS A total of 44 studies comprising 1664 patients met the inclusion criteria. The mean age ranged from 28.1 to 67 years and there were 28.4% females. The pooled procedural success rate was 87% (95% CI 83.9-89.6, I2 = 53%). Age (OR 0.95, 95% CI 0.91-1) and hereditary hemorrhagic telangiectasia ([HHT], OR 0.97, 95% CI 0.96-0.99) were associated with decreased odds of success. The pooled rebleeding rate was 16.4% (95% CI 13.6-19.6, I2 = 48%), and HHT was associated with greater odds of rebleeding (OR 1.02, 95% CI 1-1.03). The pooled overall complication rate was 14.4% (95% CI 9.8-20.6, I2 = 85.8%). The pooled rates of stroke and vision loss were 2.1% (95% CI 1.5-3.1, I2 = 1.5%) and 1.8% (95% CI 1.2-2.6, I2 = 0%), respectively. CONCLUSION EE for epistaxis has a high rate of procedural success. Interventionalists should be aware of the risk for rebleeding, especially among patients with HHT.
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Affiliation(s)
- Haydn Hoffman
- Department of Neurosurgery, State
University of New York Upstate, Syracuse, NY, USA
| | - Apeksha Ashok Kumar
- Department of Neurosurgery, State
University of New York Upstate, Syracuse, NY, USA
| | | | - Hesham E Masoud
- Department of Neurology, State
University of New York Upstate, Syracuse, NY, USA
| | - Grahame C Gould
- Department of Neurosurgery, State
University of New York Upstate, Syracuse, NY, USA
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Salcan I, Olgun A. Is There a Relationship Between Epitaxis and Anatomical Variations? Eurasian J Med 2019; 52:136-138. [PMID: 32612420 DOI: 10.5152/eurasianjmed.2020.19222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/05/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of our study is to introduce the relationship between epistaxis and anatomical variations and present the current treatment approach. Materials and Methods Forty-five patients (28 males and 17 females) that presented to otorhinolaryngology clinics at Mengucek Gazi Training and Research Hospital with pre-diagnosed epistaxis between October 2018 and April 2019 were included in the study. Age, sex and structural causes and anatomical localization of epistaxis in patients were analysed. Results The median age of the patients was 42, ranging from 20 to 60 years. Focus of bleeding was observed on the right in 16 cases (35.5%), left in 14 cases (31.1%) and bilateral in nasal cavity in 15 cases (33.3%). Bleeding was from the anterior septum in front of the maxillary ostium line. Anatomical variations were seen in 31 patients (68.8%) (septal deviation in 12, septal perforation in two, and concha hypertrophy in 17). Conclusion Epistaxis is one of the most common ear, nose, and throat emergencies. Etiological reasons must be analysed for the treatment to be effective.
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Affiliation(s)
- Ismail Salcan
- Department of Ear Nose and Throat, Erzincan University School of Medicine, Mengucek Training and Research Hospital, Erzincan, Turkey
| | - Abdulkerim Olgun
- Department of Plastic Reconstructive and Aesthetic Surgery, Ataturk University School of Medicine, Erzurum, Turkey
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Brown CS, Abi-Hachem R, Jang DW. Management of epistaxis in patients with ventricular assist device: a retrospective review. J Otolaryngol Head Neck Surg 2018; 47:48. [PMID: 30068378 PMCID: PMC6090909 DOI: 10.1186/s40463-018-0295-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/27/2018] [Indexed: 11/17/2022] Open
Abstract
Background Patients with a ventricular assist device (VAD) are at risk for epistaxis due to the need for anticoagulation. Additionally, these patients develop acquired von Willebrand syndrome (AvWS) due to these devices. Management is complicated by the risk of thrombosis if anticoagulation is reversed. This study sought to characterize the clinical features and management of epistaxis in this high-risk population. Methods Retrospective review of adults with VAD and epistaxis necessitating inpatient consultation with the otolaryngology service were included. Results 49 patients met inclusion criteria. All patients had a presumed diagnosis of AvWS. An elevated INR (> 2.0) was present in 18 patients (36.7%). Anticoagulation was held in 14 (28.6%) patients, though active correction was not necessary. Multiple encounters were required in 16 (32.7%) patients. Spontaneous epistaxis was associated with multiple encounters (p = 0.02). The use of hemostatic material was associated with a lower likelihood of bleeding recurrence (p = 0.05), whereas cauterization with silver nitrate alone was associated with a higher likelihood of re-intervention (p = 0.05). Surgery or embolization was not required urgently for any patient. Endoscopy under general anesthesia was performed for one patient electively. Mean follow up time was 16.6 months (σ = 6.3). At six months, 18 (36.7%) patients were deceased. Conclusion While these patients are at risk for recurrent spontaneous epistaxis, nonsurgical treatment without active correction of INR or AvWS was largely successful. Placement of hemostatic material, as opposed to cautery with silver nitrate, should be considered as a first-line treatment in this group. Multidisciplinary collaboration is critical for successful management.
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Affiliation(s)
- Clifford Scott Brown
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, DUMC 3805, Durham, NC, 27710, USA.
| | - Ralph Abi-Hachem
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, DUMC 3805, Durham, NC, 27710, USA
| | - David Woojin Jang
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, DUMC 3805, Durham, NC, 27710, USA
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Lee JJ, Lee E, Ryu G, Seo MY, Hong SD, Kim HY, Dhong HJ, Chung SK. Efficacy of Endoscopic Electrocauterization for Recurrent Posterior Epistaxis. JOURNAL OF RHINOLOGY 2018. [DOI: 10.18787/jr.2018.25.2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jung Joo Lee
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eunkyu Lee
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gwanghui Ryu
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Young Seo
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Duk Hong
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyo Yeol Kim
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hun-Jong Dhong
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Kyu Chung
- Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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