12
Treatment
Figure 5. Epistaxis Guideline Key Action Statements
KAS1
Nasal Compression
NO
KAS2
NO
KAS6
Option of 1 or More of
Following:
• Topical Vasoconstrictors
• Lubricants
• Nasal Cautery
Patient with Nosebleed
Anterior Rhinoscopy
with or without Nasal
Endoscopy
YES
Needs Prompt
Management?
YES
Bleeding
Controlled?
NO
YES
Active
Bleeding?
KAS8
Risk Factor Assessment
KAS5
Assess for HHT
If Recurrent Bilateral
Bleeds and Family Hx of
Nosebleeds
KAS12
Anterior Rhinoscopy
with or without Nasal
Endoscopy
KAS6, KAS7A, KAS7B
Bleeding Site
Identified?
YES
Suspected
Bleeding
Disorder, HHT, or on
Anticoagulants?
NO
Non-Absorbable
or Absorbable
Packing
Absorbable
Packing
YES
NO
Nasal Packing Education
KAS4
Anesthetize Bleeding Site and
Limit Nasal Cautery to Site
KAS9
Bleeding
Controlled?
NO
Is Patient on
Anti-coagulants
or Anti-Platelet
Medications?
Life-
Threatening Nasal
Bleeding?
KAS11
NO
NO
YES
YES
Assess Need for and Risks of
Reversal or Discontinuation of Anti-
Coag/Anti-Platelet Medications
YES
KAS3A, KAS3B
