Topical Tranexamic Acid with Nasal Compression Controls Epistaxis

Topical tranexamic acid worked as well as a nasal tampon for anterior nosebleeds in a randomized trial.

Recent trials have demonstrated that topical tranexamic acid controls epistaxis, but they compared tranexamic acid–soaked cotton pledgets to packing with cotton pledgets and topical vasoconstrictors (NEJM JW Emerg Med Jan 2018 and Acad Emerg Med 2018; 25:261; Am J Emerg Med 2013; 31:1389). In the U.S., nasal tampons are more commonly used for packing than cotton pledgets.

Researchers in Turkey compared the efficacy of Merocel (a commercially available nasal tampon), atomized tranexamic acid with nasal compression, and atomized 0.9% saline placebo with nasal compression in 135 adults (median age, 60 years) with active spontaneous anterior epistaxis. Exclusion criteria were anticoagulation or bleeding disorder, traumatic epistaxis, altered men…

Reviewing Author

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Topical Tranexamic Acid with Nasal Compression Controls Epistaxis

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Reviewing Author