Initial management of epistaxis includes which step?

Initial management of epistaxis includes which step?

• A. Packing without prior pressure
• B. Lean forward with direct pressure to the nose for 20 minutes
• C. Immediate surgical intervention
• D. Systemic antibiotics

Answer: (B)

Controlling a simple anterior nosebleed starts with mechanical tamponade: apply firm, continuous direct pressure to the bleeding site for a sustained period, typically about 20 minutes. Pressing the soft part of the nose against the nasal septum helps form a clot at the bleeding source, often Kiesselbach’s plexus, without needing invasive steps yet. Leaning forward during this maneuver is important because it prevents blood from running back into the throat and reduces the risk of aspiration; tilting the head back can cause swallowing of blood and does not aid clot formation. If bleeding stops after this maneuver, you’ve achieved initial control. If it persists, escalation with topical vasoconstrictors, anterior nasal packing, or cauterization may be needed. Systemic antibiotics or immediate surgical intervention are not initial management steps for a typical epistaxis.

Controlling a simple anterior nosebleed starts with mechanical tamponade: apply firm, continuous direct pressure to the bleeding site for a sustained period, typically about 20 minutes. Pressing the soft part of the nose against the nasal septum helps form a clot at the bleeding source, often Kiesselbach’s plexus, without needing invasive steps yet. Leaning forward during this maneuver is important because it prevents blood from running back into the throat and reduces the risk of aspiration; tilting the head back can cause swallowing of blood and does not aid clot formation.

If bleeding stops after this maneuver, you’ve achieved initial control. If it persists, escalation with topical vasoconstrictors, anterior nasal packing, or cauterization may be needed. Systemic antibiotics or immediate surgical intervention are not initial management steps for a typical epistaxis.