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
Immediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):
Nil To contact the relevant service, see Clinician Assist WA: Acute ENT assessment (external site)

Clinical indications for outpatient referral
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 in regional or remote areas or due to financial reason). 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 clinical urgency 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

Indicative clinical urgency category

Category 1

Appointment within 30 days

Category 2

Appointment within 90 days

Category 3

Appointment within 365 days

Exclusions
Nil

Useful information
Nil

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Last reviewed: 02-10-2023

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