Clinical Case Database / Category: Patient Management


Publication details

Stephanie Edwards, MBChB, MRCS, Vinod Prabhu, FRCS (ORL), Conor Marnane, FRCS (ORL)
Foundation Years Journal, volume 7, issue 4, p.10 (123Doc Education, London, April 2013)


A 59-year-old man presents to the A&E department with a right sided epistaxis. He states that the bleeding started in the early hours of the morning and would not stop with simple nasal pressure. He is unable to estimate how much blood he has lost, but brings with him a number of blood-stained tissues. He mentions that he has had some smaller bleeds recently but did not need to seek medical assistance. He has a history of hypertension and takes aspirin. He is actively bleeding on presentation.

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Stephanie Edwards, MBChB, MRCS

Singleton Hospital,
Swansea, UK

Vinod Prabhu, FRCS (ORL)

Specialist Registrar ENT
Singleton Hospital,
Swansea, UK

Conor Marnane, FRCS (ORL)

Consultant Otolaryngologist – Head and Neck Surgery
Singleton Hospital,
Swansea, UK


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4. Beer HL et al. Blood loss estimation in epistaxis scenarios. JLO. 2005;119:16-18.
5. Melia L, McGarry GW. Epistaxis: update on management. Curr Opin Otolaryngol Head Neck Surg. 2011;19:30-35.
6. Pope LER, Hobbs CGL. Epistaxis: an update on current management. Postgrad Med J. 2005;81:309–314.
7. Pringle MB, Beasley P, Brightwell AP. The use of Merocel nasal packs in the treatment of epistaxis. JLO. 1996;110:543-546.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.