Epistaxis laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
[[Laboratory]] findings are usually normal among [[patients]] with [[epistaxis]], but when [[bleeding]] is heavy or [[physician]] | [[Laboratory]] findings are usually normal among [[patients]] with [[epistaxis]], but when [[bleeding]] is heavy or [[physician]] is suspicious to [[coagulopathy]], the following tests should be performed: [[CBC]], [[Prothrombin time|PT]], [[Partial thromboplastin time|PTT]], [[Bleeding time|BT]]. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory findings are usually normal among patients with [[epistaxis]], but when [[bleeding]] is heavy or [[physician]] is suspicious to [[coagulopathy]], | Laboratory findings are usually normal among patients with [[epistaxis]], but when [[bleeding]] is heavy or [[physician]] is suspicious to [[coagulopathy]], the following studies should be considered:<ref name="KrulewitzFix2019">{{cite journal|last1=Krulewitz|first1=Neil Alexander|last2=Fix|first2=Megan Leigh|title=Epistaxis|journal=Emergency Medicine Clinics of North America|volume=37|issue=1|year=2019|pages=29–39|issn=07338627|doi=10.1016/j.emc.2018.09.005}}</ref> <ref name="ThorntonMahesh2005">{{cite journal|last1=Thornton|first1=M A.|last2=Mahesh|first2=B N.|last3=Lang|first3=J|title=Posterior Epistaxis: Identification of Common Bleeding Sites|journal=The Laryngoscope|volume=115|issue=4|year=2005|pages=588–590|issn=0023852X|doi=10.1097/01.mlg.0000161365.96685.6c}}</ref> <ref name="RechtChitlur2017">{{cite journal|last1=Recht|first1=Michael|last2=Chitlur|first2=Meera|last3=Lam|first3=Derek|last4=Sarnaik|first4=Syana|last5=Rajpurkar|first5=Madhvi|last6=Cooper|first6=David L.|last7=Gunawardena|first7=Sriya|title=Epistaxis as a Common Presenting Symptom of Glanzmann’s Thrombasthenia, a Rare Qualitative Platelet Disorder: Illustrative Case Examples|journal=Case Reports in Emergency Medicine|volume=2017|year=2017|pages=1–6|issn=2090-648X|doi=10.1155/2017/8796425}}</ref> | ||
* [[Complete blood count]] ([[CBC]]): Reduced [[hemoglobin]] level is important for [[bleeding]] [[management]] in [[patients]] with heavy and recurrent [[epistaxis]]. | *[[Complete blood count]] ([[CBC]]): Reduced [[hemoglobin]] level is important for [[bleeding]] [[management]] in [[patients]] with heavy and recurrent [[epistaxis]]. | ||
*[[Platelet count]]: Reduced [[platelet count]] is important to find the [[Causes|cause]] and for the [[management]] of [[patients]] with heavy and recurrent [[epistaxis]]. | *[[Platelet count]]: Reduced [[platelet count]] is important to find the [[Causes|cause]] and for the [[management]] of [[patients]] with heavy and recurrent [[epistaxis]]. | ||
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These laboratory tests should be requested in the presence of red flags such as: | These laboratory tests should be requested in the presence of red flags such as: | ||
*The following findings are of particular concern: | *The following findings are of particular concern: | ||
*[[Hemorrhagic shock]] or [[hypovolemic]] signs | *[[Hemorrhagic shock]] or [[hypovolemic]] signs | ||
Revision as of 22:51, 13 January 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D.
Overview
Laboratory findings are usually normal among patients with epistaxis, but when bleeding is heavy or physician is suspicious to coagulopathy, the following tests should be performed: CBC, PT, PTT, BT.
Laboratory Findings
Laboratory findings are usually normal among patients with epistaxis, but when bleeding is heavy or physician is suspicious to coagulopathy, the following studies should be considered:[1] [2] [3]
- Complete blood count (CBC): Reduced hemoglobin level is important for bleeding management in patients with heavy and recurrent epistaxis.
- Platelet count: Reduced platelet count is important to find the cause and for the management of patients with heavy and recurrent epistaxis.
- Prothrombin time (PT): Increased PT is important to find the cause and management patients with heavy and recurrent epistaxis.
- Partial thromboplastin time (PTT): Increases PTT is important evaluate if there is any coagulopathy and for the management of such patients.
- Bleeding time (BT): Increased BT is also important to evaluate for coagulopathies and management.
These laboratory tests should be requested in the presence of red flags such as:
- The following findings are of particular concern:
- Hemorrhagic shock or hypovolemic signs
- Use of anticoagulants
- Cutaneous signs of a bleeding disorder
- Persistent bleeding or bleeding that is not stopped by direct pressure or vasoconstrictor-soaked pledgets
- Multiple recurrences with no clear cause
References
- ↑ Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
- ↑ Thornton, M A.; Mahesh, B N.; Lang, J (2005). "Posterior Epistaxis: Identification of Common Bleeding Sites". The Laryngoscope. 115 (4): 588–590. doi:10.1097/01.mlg.0000161365.96685.6c. ISSN 0023-852X.
- ↑ Recht, Michael; Chitlur, Meera; Lam, Derek; Sarnaik, Syana; Rajpurkar, Madhvi; Cooper, David L.; Gunawardena, Sriya (2017). "Epistaxis as a Common Presenting Symptom of Glanzmann's Thrombasthenia, a Rare Qualitative Platelet Disorder: Illustrative Case Examples". Case Reports in Emergency Medicine. 2017: 1–6. doi:10.1155/2017/8796425. ISSN 2090-648X.