Patients experiencing severe nose bleeds are avoiding unnecessary stays in hospital thanks to a change of treatment pathway at Hull Royal Infirmary’s Emergency Department.

Becky Collingwood and Philip Johnson, Advanced Clinical Practitioners (ACPs) at NHS Humber Health Partnership, trialled a new way of helping patients with severe nose bleeds, known as epistaxis.

Around 60pc of the population will experience epistaxis although only six per cent will need medical attention. Previously, those patients had to undergo first aid, silver nitrate cautery and the potentially traumatic insertion of nasal packs.

Now, patients are given an injection of Floseal liquid to halt the bleeding, with results showing almost two-thirds of patients rushed to Hull Royal’s Emergency Department were able to go home following the application of the liquid instead of being admitted to Castle Hill.

ACPs Becky Collingwood and Philip Johnson

Philip said: “It’s a far better experience for patients as they can go home to recover instead of having an invasive and potentially uncomfortable procedure then a stay in hospital for observation following what can be a traumatic event in the first place.”

Patients of all ages can experience epistaxis although it can affect older people who have thinner blood vessels or may be on blood-thinning medication. It’s common in children over two and peaks in children younger than 10 and in adults aged between 70 and 79

During the trial between December and February, the average age of patients attending ED with nose bleeds was 71 and they were seen by a member of the Ear, Nose and Throat (ENT) team in the Minors Unit, the Resus Department and the Same Day Emergency Care Unit.

Becky said before the new trial, some patients faced overnight stays after the nasal packs were inserted but others faced longer stays, resulting in an increased risk of infection and potential muscle wastage linked to stays in hospital.

“With the new treatment, the liquid is applied into the nostril directly and it hardens in the nostril to control the bleeding,” Becky said. “There is no need for removal as the hardened liquid dissolves over the following six weeks so there’s less discomfort for patients and, more importantly, there’s no need for hospital admission.”

Not only is providing a better patient experience, the new treatment costs around one-fifth of the cost of transfer and admission to hospital, saving the NHS around £10,000 during the trial.

Becky said: “We’re now using the results to create a more formal pathway so this treatment can be offered to all appropriate patients who come to us with severe nose bleeds.”