Abstract
Introduction :
In March 2020, new guidelines allowed patients with epistaxis to be
discharged home with nasal packs in situ to reduce the risk of inpatient
covid transmission rates. Our objective is to review how successful
these new guidelines have been and whether they could be safely
maintained in future practice.
Methods :
This was a retrospective data analysis at a local tertiary ENT referral
hospital. The study group consisted of patients admitted with epistaxis
over one year. The “Pack and Home” criteria pathway was implemented.
We reviewed the pathway 6 months pre and 6 months post pathway
introduction. Primary outcome measure included compliance with the
“Pack and Home” criteria and length of inpatient admissions.
Results :
A total of 131 patients required nasal packing, with 72 patients (55%)
in loop 1 and 59 patients (45%) in loop 2. In the first loop all 72
patients (100%) were admitted for inpatient care. However, in the
second loop 21 patients (36%) were discharged home with nasal pack in
situ and 59 patients (64%) were admitted. Of those discharged, 2
patients re-presented after 48 hours with re-bleeding. The average total
length of inpatient stay in loop 1 was significantly higher at 45.7
hours and 29.6 hours in loop 2 (p<0.05). All discharged
patients attended their outpatient appointment in under 3 days.