Conclusion
Our study has demonstrated the potential to reduce epistaxis admissions by including a TXA-soaked dissolvable pack step in the A&E epistaxis treatment algorithm. In order to achieve this reduction in admissions, education of A&E clinicians was required and it is important that this is repeated on a regular basis in order to maintain the results observed.
The implementation of this treatment algorithm across the UK requires A&E departments to be well stocked with supplies of NasoPore® and TXA, and for clinicians to be comfortable using these. Larger scale studies would be helpful to determine the feasibility of introducing this pathway in both A&E and pre-hospital settings, and also to assess patient experience and satisfaction with dissolvable versus non-dissolvable nasal packing. Next steps include re-assessment to assess long term adherence and the post-covid validity.