Epistaxis Severity Score (ESS)
Quantifies epistaxis severity to guide management from first aid to surgical intervention. Considers frequency, volume, and haemodynamic impact.
Score interpretation
→ First aid (pinch soft part nose 10-15 min); chemical cautery in clinic if recurrent; review anticoagulants/antiplatelet
→ Anterior nasal packing; check FBC, clotting; ENT review; consider BSLEAP, TXA nasal spray; cautery under LA
→ Hospital admission; posterior packing or balloon; IV access, cross-match; sphenopalatine artery ligation or embolisation; haematology review if coagulopathy
Interpretation bands for the Epistaxis Severity. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Silver Nitrate · Chemical Cautery — Epistaxis
- Naseptin Nasal Cream · Nasal Decolonisation / Recurrent Epistaxis
- Mupirocin 2% Ointment · Topical antibiotic (pseudomonic acid)
- Chlorhexidine with neomycin · Topical nasal antiseptic/antibiotic
- Glucagon · Hypoglycaemia Antidote / Endocrine Agent
- Budesonide Nasal Spray · Intranasal corticosteroid
- Adult Upper Airway Obstruction (Stridor) · DAS 2015 unanticipated difficult airway; RCEM
- Epistaxis Management · ENT-UK / NICE
- Acute Otitis Media · NICE NG91 2018
- Tonsillitis and Sore Throat · NICE NG84 2018
- Benign Paroxysmal Positional Vertigo · NICE CG124 / AAO-HNS Guidelines
- Acute Rhinosinusitis · NICE NG79 2017 / EPOS 2020
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.