Investigations

If the patient is normally fit and well, without significant co-morbidity, history or evidence of coagulopathy and disturbance of haemodynamic observations, formal blood tests are not required.

Clearly, however, the presence of any of these factors should prompt appropriate investigation which may include blood tests, ECG and x-rays.

The ordering of routine coagulation studies has been the subject of two retrospective case reviews, which concluded that they are unnecessary, unless there is a personal or family history of a coagulation disorder. [16]

Learning bite

Coagulation studies should not be ordered in patients with epistaxis unless there is a personal or family history of a coagulation disorder.