Epistaxis (recurrent) Referral Access Criteria
Epistaxis (recurrent) Referral Access Criteria
Referrers should use this page when referring patients to public paediatric ENT outpatient services for epistaxis (recurrent). This RAC is applicable to referrals for patients aged <16 years only. Please refer to the ENT (Adult) RAC for referrals for patients aged 16 years or more.
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| 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. |
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Foreign body (button batteries – inhaled or ingested). If suspicion of button battery immediate emergency review
- Trauma with other associated injuries i.e. other facial fractures e.g. orbit
- Periorbital cellulitis with or without swelling with or without sinusitis
- Severe or persistent epistaxis
- Septal haematoma
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| Clinical indications for outpatient referral |
| If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS). |
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Epistaxis (blood nose) recurrent
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| 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.
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| History |
- Relevant history of symptoms including frequency of episodes and approximate volume
- Details of previous treatment and outcome
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| Examination |
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| Investigations |
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| Highly desirable |
| History |
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| Examination |
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| Investigations |
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FBC
- COAGs result including Von Willebrand screening if suspected blood dyscrasia
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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Epistaxis with suspicion of a tumour
- Unilateral epistaxis in adolescent male/suspicion of juvenile nasopharyngeal angiofibroma (JNA)
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Category 2
Appointment within 90 days
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- Severe recurrent epistaxis resulting in anaemia
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Category 3
Appointment within 365 days
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- Epistaxis not responding to maximal medical management for > 6 to 8 weeks e.g. topical creams, no nose picking, manage allergic rhinitis
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Last reviewed: 27-05-2024