{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:10:15Z","timestamp":1790269815054,"version":"4.1.0"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011384","name":"British Rhinological Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011384","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate factors affecting the haemostatic success of non\u2010dissolvable intranasal packs in the management of acute epistaxis presenting to the emergency department (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A nationwide prospective audit examining epistaxis management at 113 sites in the UK over a 30\u2010day period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients 16\u00a0years or older, presenting to the ED with acute epistaxis managed with non\u2010dissolvable intranasal packs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The primary outcome was pack success, defined as successful haemostasis following nasal pack removal, not requiring further packing or surgical intervention or interventional radiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A cohort of 969 patients presented with epistaxis to the ED, with nasal packs being inserted in 54.4% by ED staff and by ENT in a further 18.9%. Overall, nasal packs were successful in 87.5%. Longer duration packs (\u226521\u00a0hours) were more successful than shorter\u2010duration packs (89.9% vs. 84.3%, \u03c7<jats:sup>2<\/jats:sup> <jats:italic>P<\/jats:italic>\u00a0=\u00a0.028). A patient survey supported longer packing duration. The most significant predictors of treatment failure were shorter packing duration (Odds Ratio (OR)\u00a0=\u00a02.3; 95% Confidence Interval (CI)\u00a0=\u00a01.4\u20103.8), alongside ischaemic heart disease (OR\u00a0=\u00a01.9; 95% CI\u00a0=\u00a01.1\u20103.3), normal admission haemoglobin (OR\u00a0=\u00a02.0; 95% CI\u00a0=\u00a01.2\u20103.4) and no attempt at cautery following pack removal (OR\u00a0=\u00a02.5; 95% CI\u00a0=\u00a01.4\u20104.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The majority of epistaxis patients are packed by the ED prior to referral to ENT. Once inserted, nasal packs are highly successful, with data supporting the British Rhinological Society guidance of maintaining nasal packs for around 24\u00a0hours. Further work is needed to explore alternatives to non\u2010dissolvable intranasal packs to improve patient experience in epistaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13555","type":"journal-article","created":{"date-parts":[[2020,4,19]],"date-time":"2020-04-19T12:09:14Z","timestamp":1587298154000},"page":"659-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Nasal Packs for Epistaxis: Predictors of Success"],"prefix":"10.1111","volume":"45","author":[{"name":"INTEGRATE (The UK ENT Trainee Research Network)","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"129","article-title":"The frequency of epistaxis in a male population sample","volume":"13","author":"Petruson B","year":"1975","journal-title":"Rhinology"},{"issue":"131","key":"e_1_2_12_3_1","first-page":"1131","article-title":"Epistaxis 2016: National audit of management","volume":"2017","author":"INTEGRATE (National ENT Trainee Research Network)","year":"2016","journal-title":"J Laryngol Otol"},{"key":"e_1_2_12_4_1","unstructured":"National Institute for Health and Care Excellence.Clinical Knowledge Summaries. Epistaxis n.d.https:\/\/cks.nice.org.uk\/epistaxis\u2010nosebleeds[2 August 2017]."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117002018"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117002055"},{"key":"e_1_2_12_7_1","unstructured":"Health Protection Agency.English National Point Prevalence Survey on Healthcare\u2010associated Infections and Antimicrobial Use 2011. andhttps:\/\/webarchive.nationalarchives.gov.uk\/20140714085429\/http:\/\/www.hpa.org.uk\/Publications\/InfectiousDiseases\/AntimicrobialAndHealthcareAssocia"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2339-2"},{"key":"e_1_2_12_9_1","first-page":"202","article-title":"Duration of nasal packs in the management of epistaxis","volume":"25","author":"Kundi NA","year":"2015","journal-title":"J Coll Physicians Surg Pakistan"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.2005.01019.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100125770"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27604"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13555","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.13555","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13555","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T10:17:05Z","timestamp":1692958625000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.13555"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,5]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1111\/coa.13555"],"URL":"https:\/\/doi.org\/10.1111\/coa.13555","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,5]]},"assertion":[{"value":"2019-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}