Routine laboratory testing is not necessary to diagnose Epistaxis. Complete blood count (CBC), prothrombin time (PT), and partial thromboplastin time tests should be performed on patients with severe or recurring epistaxis as well as those who exhibit symptoms or signs of a bleeding problem (PTT). If a tumour, foreign body, or sinusitis are suspected, a CT scan may be performed.
Usually, squeezing the nasal alae together for ten minutes while the patient is seated upright will stop bleeding (if possible). If this tactic doesn't work, the nose is pinched for another 10 minutes using a cotton pledget that has been soaked with a vasoconstrictor (like phenylephrine 0.25%) and a topical anaesthetic (like lidocaine 2%). The bleeding spot can then be cauterised using silver nitrate applied with an applicator stick or by electrocautery. Cautioning the four quadrants closest to the bleeding vessel works best. The mucosal membrane must not be burned too severely, hence silver nitrate is the recommended treatment.
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