Discharging:

This *** patient presents with epistaxis, which appears to have minimal bleeding***resolved. There are no risk factors for bleeding disorders and the patient is hemodynamically stable. No evidence of anemia. Will treat supportively.

Intervention needed: 

This *** patient on AC//no AC presents with active epistaxis requiring intervention. The patient is hemodynamically stable without evidence of symptomatic anemia. Will treat with direct pressure, oxymetazoline PRN, and possibly placement of packing with TXA or a rhino-rocket if not able to control bleeding. Will also offer patient the option of silver nitrate cautery if a bleeding vessel is identified.

Plan: direct pressure, oxymetazoline IN, consider TXA, packing, rhino-rocket, +/- ENT consult

ENT/Admit Needed: 

This *** patient on ***AC presents with active, uncontrolled epistaxis. The patient has symptoms of anemia secondary likely to the epistaxis. Protecting airway at this time. Will attempt ED measures to control bleeding (direct pressure, anterior/posterior packing, tranexamic acid). Patient will require ENT consult for potential cautery/intervention and likely admit for symptomatic anemia and observation.