Epistaxis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D.

Laboratory findings are usually normal among patients with epistaxis, but when bleeding is heavy or physician is suspicious to coagulopathy, the following tests should be performed: CBC, PT, PTT, BT.

Laboratory findings are usually normal among patients with epistaxis, but when bleeding is heavy or physician is suspicious to coagulopathy, the following studies should be considered:^{[1] [2] [3]}

• Complete blood count (CBC): Reduced hemoglobin level is important for bleeding management in patients with heavy and recurrent epistaxis.

• Platelet count: Reduced platelet count is important to find the cause and for the management of patients with heavy and recurrent epistaxis.
• Prothrombin time (PT): Increased PT is important to find the cause and management patients with heavy and recurrent epistaxis.
• Partial thromboplastin time (PTT): Increases PTT is important evaluate if there is any coagulopathy and for the management of such patients.
• Bleeding time (BT): Increased BT is also important to evaluate for coagulopathies and management.

These laboratory tests should be requested in the presence of red flags such as:

• The following findings are of particular concern:
• Hemorrhagic shock or hypovolemic signs
• Use of anticoagulants
• Cutaneous signs of a bleeding disorder
• Persistent bleeding or bleeding that is not stopped by direct pressure or vasoconstrictor-soaked pledgets
• Multiple recurrences with no clear cause

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