Methodology Score: 2.5/5
Usefulness Score: 2.5/5
Akkan S, et al. Ann Emerg Med. 2019 Jul;74(1):72-78
Question and Methods: Prospective RCT comparing compression with saline, compression with tranexamic acid, and nasal packing with merocel for anterior epistaxis.
Findings: No difference in 15-minute bleeding cessation for TXA (91.1%) or packing (93.3%), v/s saline (71.1%). Lower 24h rebleeding for TXA (86.7%) compared to packing (74%).
Limitations: Blinding not possible for packing and outcomes are subjective leading to potentially significant performance bias.
Interpretation: For anterior epistaxis, compression with TXA and nasal packing are feasible. More studies are needed to prove clinically significant differences in outcomes.
