How can I educate patients on self-management techniques to prevent future episodes of epistaxis?

To educate patients on self-management techniques to prevent future episodes of epistaxis, it is essential to provide clear, practical advice on first aid during bleeding and on post-episode care to reduce recurrence. Patients should be instructed to sit with their upper body tilted forward and mouth open during a nosebleed, avoiding lying down unless feeling faint, and to firmly pinch the soft part of the nose for 10–15 minutes without releasing pressure while breathing through the mouth. This technique helps control acute bleeding effectively ¹.

After a nosebleed, patients should avoid blowing or picking their nose, heavy lifting, strenuous exercise, lying flat, and consuming alcohol or hot drinks for 24 hours to prevent re-bleeding ¹. Providing written information, such as patient leaflets from ENT UK, supports understanding and retention of these self-care measures ¹.

It is also important to assess for any underlying causes of recurrent epistaxis, especially in children under 2 years or adults with frequent episodes, and refer to specialists if serious conditions are suspected ¹. For patients without high-risk features, topical antiseptic treatments like Naseptin® (chlorhexidine and neomycin) or mupirocin nasal ointment can be prescribed to reduce crusting and inflammation, which may help prevent further bleeding ¹.

Education should emphasize the importance of adherence to these topical treatments and avoidance of nasal trauma. Additionally, patients should be informed about the signs that warrant medical review, such as persistent or severe bleeding, nasal obstruction, or symptoms suggestive of tumors or telangiectasia ¹.

From a broader patient education perspective, ensuring information is accessible and tailored to the patient's cultural, linguistic, and literacy needs enhances self-management capabilities. Encouraging patients to engage in evidence-based educational activities and providing consistent, clear communication improves confidence in managing their condition ⁵.

While oral tranexamic acid is sometimes considered to reduce re-bleeding risk in adults with epistaxis, evidence is limited and should be discussed with healthcare professionals before use ¹ (Tunkel et al., 2020).