Merdad Mazin, Sanad Saad A, Alelyani Rakan H, Alkhammash Abdulaziz M, Swead Faisal M, Alghamdi Oday M
Otolaryngology - Head and Neck Surgery, King Abdulaziz University, Jeddah, SAU.
College of Medicine, King Abdulaziz University, Jeddah, SAU.
Cureus. 2022 Aug 19;14(8):e28155. doi: 10.7759/cureus.28155. eCollection 2022 Aug.
Background Epistaxis refers to bleeding from the inside of the nose or nasal cavity. It is one of the most prevalent otorhinolaryngology emergencies. It is generally treated with simple conservative measures, although it can sometimes be life-threatening. In most cases, using simple first-aid measures that involve tilting the patient's head forward to reduce the risk of blood aspiration and applying digital compression to the nasal alae and anterior septal area for 10-15 minutes will stop the nosebleeds in 90%-95% of cases. This study aims to assess health care providers' knowledge of epistaxis first-aid measures. Methods This cross-sectional study was conducted via an electronic questionnaire of multiple-choice questions. The survey was randomly sent through WhatsApp (Google Inc) to all health care providers and medical students who met the inclusion criteria. The study's inclusion criteria included emergency care providers, primary care providers, otolaryngology and head and neck surgery residents, and second-year medical students. In addition, Oto-HNS residents and medical students were included as a control. Respondents were asked to recognize where to apply nasal compression and what is the correct position of the patient's head during an epistaxis episode. Results Thirty percent of health care providers answered correctly to the site of nose compression, and 66% for the correct head position. When evaluating the answers to both questions collectively, 31% of EM consultant physicians, 18% of EM residents, 24% of FM consultant physicians, 40% of family medicine residents, 13% of ED nurses, 28% of house officers, 69% of Oto-HNS residents and 17% of the second-year medical students responded to both questions correctly. A large proportion of those who responded incorrectly to either of the questions stated they were "very confident" about their response. Conclusion Even though primary and emergency care providers see many epistaxis patients, this study found that the majority of EM consultant physicians, EM residents, ED nurses, FM consultant physicians, FM residents, and house officers surveyed in this study could not identify first-aid measures for epistaxis appropriately. Increased otolaryngology training might help primary and emergency care providers by increasing their understanding of epistaxis first-aid measures often seen in their practices.
背景 鼻出血是指鼻腔内部出血。它是耳鼻喉科最常见的急症之一。虽然有时可能危及生命，但一般采用简单的保守措施进行治疗。在大多数情况下，采取简单的急救措施，即让患者头部前倾以降低血液吸入风险，并对鼻翼和鼻中隔前部区域进行指压10 - 15分钟，90% - 95%的鼻出血情况可止血。本研究旨在评估医疗保健提供者对鼻出血急救措施的了解程度。方法 本横断面研究通过多项选择题电子问卷进行。该调查通过WhatsApp（谷歌公司）随机发送给所有符合纳入标准的医疗保健提供者和医学生。该研究的纳入标准包括急救护理人员、初级护理人员、耳鼻喉科和头颈外科住院医师以及二年级医学生。此外，耳鼻喉科住院医师和医学生作为对照纳入。受访者被要求识别鼻出血发作时在何处进行鼻腔压迫以及患者头部的正确位置。结果 30%的医疗保健提供者正确回答了鼻腔压迫部位，66%正确回答了头部正确位置。综合评估两个问题的答案时，31%的急诊顾问医师、18%的急诊住院医师、24%的家庭医学顾问医师、40%的家庭医学住院医师、13%的急诊护士、28%的住院医生、69%的耳鼻喉科住院医师和17%的二年级医学生两个问题都回答正确。对其中任何一个问题回答错误的人中，很大一部分表示对自己的回答“非常有信心”。结论 尽管初级和急救护理人员会接触到许多鼻出血患者，但本研究发现，本研究中接受调查的大多数急诊顾问医师、急诊住院医师、急诊护士、家庭医学顾问医师、家庭医学住院医师和住院医生都不能正确识别鼻出血的急救措施。增加耳鼻喉科培训可能有助于初级和急救护理人员，提高他们对在实际工作中常见的鼻出血急救措施的理解。
