Author: Jonathan D Whittaker / Editor: Jonathan D Whittaker / Reviewer: Michael Perry, Alison Hay / Codes: EP3, SLO1, SLO6 / Published: 02/11/2023

A 56-year-old woman is brought to the Emergency Department (ED) by her husband as she has been unable to stop a nosebleed. Both nostrils have been bleeding for the last hour despite applying pressure to the nose.

There is no history of trauma and she has never had a significant nosebleed in the past. She has had a slight head cold for the last 2 days but is normally healthy with no significant illnesses and she is not taking any medication. She has not noticed any other bleeding or abnormal bruising recently.

A series of routine observations are taken by the triage nurse:

  • Pulse 88 / minute regular
  • BP 137/88
  • Respiratory rate 18 / minute
  • Oxygen saturation 97% on air
  • Temperature 37.1oC
  • Capillary blood glucose 5.7 mmol/l

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