J Korean Soc Emerg Med.  2017 Jun;28(3):248-254. 10.0000/jksem.2017.28.3.248.

Effectiveness of Rapidrhino® Packing in Patients Who Visited Emergency Room due to Anterior Epistaxis

• Kim B
• Kwon MO
• Yang CJ
• Cho IS
• Lee KI

• KMID: 2386576
• DOI: http://doi.org/10.0000/jksem.2017.28.3.248

Abstract

PURPOSE
Although there are many treatment options for managing epistaxis, little is known about their outcomes in the emergency department (ED). In this study, we evaluated the management of epistaxis, especially comparing the efficacy between Rapidrhino® and Merocel®.
METHODS
A retrospective review of patients with epistaxis visiting the ED between January 2010 and June 2016 was performed. Haemostatic properties of packs were initially measured in the ED, and after the removal of packs in the otorhinolaryngology clinic. Subgroup analyses were performed in a similar fashion for patients receiving and not receiving anticoagulants or the antiplatelet.
RESULTS
The initial success rates for Rapidrhino® and Merocel® were both high (90.3%, 86.3%, respectively). Rebleeding rates for Rapidrhino® and Merocel® were 41.4% and 56.3%, respectively. Overall, there was a significant difference between the two types of packs in recurrence (p=0.032). Particularly, in patients with anticoagulants, the initial success rates of Rapidrhino® were higher than that of Merocel® (88.6%, 76.2%, respectively, p=0.222). The rebleeding rate of Rapidrhino® was much lower than that of Merocel® (54.3%, 85.7%, respectively, p=0.016). In the Rapidrhino® group, the rebleeding rate varied according to the packing removal date (p=0.001).
CONCLUSION
Rapidrhino® and Merocel® are equally effective in the initial arrest of epistaxis in the ED. Rapidrhino® may be more effective in controlling haemorrage on removal, particularly in patients with anticoagulants. Patients with epistaxis could be treated with Rapidrhino® in the ED, which could be removed in the outpatient clinic one day later.

Keyword

Epistaxis; Hemostasis; Emergency treatment; Anticoagulants; Platelet aggregation inhibitors

MeSH Terms

Ambulatory Care Facilities
Anticoagulants
Emergencies*
Emergency Service, Hospital*
Emergency Treatment
Epistaxis*
Hemostasis
Humans
Otolaryngology
Platelet Aggregation Inhibitors
Recurrence
Retrospective Studies
Anticoagulants
Platelet Aggregation Inhibitors