Management of epistaxis

On the field of play, if there is epistaxis a good immediate measure is to insert a dental cotton roll – pre-soaked in dental anaesthetic into each nostril and then keep pressure applied. Keep the head forward as this allows blood to run forwards and out through the nose or mouth. This “buys” a little time in obtaining haemostasis, while getting the injured player to the medical room.

If the bleeding persists despite correctly applied pressure and nasal plugs, then the medical practitioner may consider:

Specialist Nasal balloons e.g. Rapid Rhino® – these need to be inserted into each nostril and then 5-10 mls of water injected into them so that they enlarge, also use external digital pressure.

If the bleeding is not controlled then referral to an appropriate Emergency Department or on call nasal specialist is required.