Epistaxis Referral Access Criteria

Referrers should use this page when referring patients to public adult ENT outpatient services for epistaxis. 
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Severe or persistent epistaxis not ceasing despite simple or conservative measures
  • Acute nasal fracture with septal haematoma
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):
  • Nil
To contact the relevant service, see HealthPathways: Acute ENT assessment (external site)
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Epistaxis where treatment such as emollients and chemical cautery has been attempted and failed (or not available) 
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

History
  • Details of previous treatment and outcome including
    • Course of systemic and topical medications prescribed
  • Current medication list including any NSAIDS, aspirin or warfarin and anti-hypertensive medication
Examination
  • Nil
Investigations
  • Nil
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • Coagulopathy/platelet disorder screening results (where available)
Indicative triage category

Category 1

Appointment within 30 days

  • Epistaxis with no obvious cause
  • Associated change in sense of smell
  • Epiphora
  • Diplopia
  • Unilateral
  • Facial pain
  • Altered sensation in face

Category 2

Appointment within 90 days

  • No defined category 2 criteria

Category 3

Appointment within 365 days

  • Recurrent epistaxis on a background of nasal trauma
Exclusions
  • Nil
Useful information
  • Nil
Last reviewed: 02-10-2023