Material and Methods
We carried out a retrospective case series study on academic, tertiary referral settings. The project was approved by the local University Audit Committee, all participants’ data were handled complying with the regulations of University Hospital of Larissa scientific committee and according to the Helsinki and the Health Insurance Portability and Accountability (HIPAA). STROBE guideline has been followed in this study. All cases presenting with epistaxis at the ENT-emergency department within the period January 2011-May 2015 were identified from the audit database and the ENT-emergency register.
We specifically identified the cases that we discharged home (the home group) with nasal packing. We collected demographics, relevant medications, namely coagulation medication, packing material, complications and need for admission.
We included in the ‘home group’ patients who underwent nasal packing with a non-absorbable material. Patients were only admitted in cases of uncontrolled bleeding (need for surgical intervention), abnormal vital signs, posterior packing, recurrent epistaxis from the “home packing group”, haemoglobin <10g/dl, uncontrolled hypertension and high cardiac risk, and in some cases for social reasons (distance from hospital, lack of social support). All ‘home patients’ were living within a 45 minute driving distance to our centre. Written instructions and contact details were handed out to all patients; these were the safety criteria for discharging the patients. Patients were reviewed 48 hours later on outpatient settings for packing removal.
The nasal examination and the management including the nasal packing was performed by the staff of the department of ENT surgery who were competent dealing with such cases.