ABSTRACT
Epistaxis in the paediatric population is exceedingly common. Fortunately, cases of acute paediatric epistaxis are rarely severe, with most being self-limiting and managed with simple first-aid measures in the community setting. The treatment required for acute paediatric epistaxis is very much dependent on the severity, anatomical site and underlying cause of the bleed. Epistaxis can be classified either aetiologically or anatomically. Aetiological classification divides epistaxis into either 'primary/idiopathic', with no identifiable underlying cause, or 'secondary' epistaxis, which occurs as a result of a systemic condition. Anatomically speaking, epistaxis can be divided into 'anterior' or 'posterior'. Other neoplastic tumours causing mass effects and epistaxis are rare entities in the paediatric population. The child presenting with acute, severe epistaxis should be managed according to the ABCDE approach for resuscitation with a parallel attempt to arrest the epistaxis. In the very rare instance of uncontrollable or posterior paediatric epistaxis, nasal packing may be required, preceded by the application of topical anaesthesia and vasoconstrictor.
