Effectiveness of RapidRhino with epinephrine in patients who visited emergency department due to epistaxis

¹Department of Emergency Medicine, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
²Department of Emergency Medicine, Konkuk University Chungju Hospital, Chungju, Korea

Correspondence

Youngtak Yoon ,Tel: 043-843-3396, Fax: 043-840-8964, Email: leafflag@naver.com,

Received: May 12, 2023; Revised: September 5, 2023 Accepted: September 5, 2023. Published online: February 28, 2024.

ABSTRACT

Objective:
RapidRhino is widely used in emergency departments (EDs) to treat epistaxis, and we have used RapidRhino plus epinephrine empirically. In this study, we evaluated the effectiveness of RapidRhino plus epinephrine compared to RapidRhino with saline.
Method:
This prospective randomized study was performed on patients with epistaxis who visited our ED between October 2021 and January 2023. Patients were randomized to RapidRhino plus epinephrine or RapidRhino groups by drawing numbers. Subgroup analyses were performed on patients who received or did not receive anticoagulants or antiplatelets.
Results:
The overall success rates for RapidRhino with saline and RapidRhino with epinephrine were both high (92% and 94%, respectively), but the 10-minute success rates of RapidRhino with saline and RapidRhino with epinephrine were 57.4% and 78%.0%, respectively, which was a significant difference (P=0.001). In patients administered anticoagulants, initial success rate of RapidRhino with epinephrine was higher than that of RapidRhino with saline (83.3% and 62.9%, respectively, P=0.046), and these results were confirmed by adjusted logistic regression analyses-for all patients (adjusted odds ratio [aOR]=2.42; 95% confidence interval [CI], 1.28-4.58) and for patients treated with anticoagulants (aOR=6.31; 95% CI, 1.17-34.17).
Conclusion:
RapidRhino with epinephrine may be more effective at controlling hemorrhage than RapidRhino. The combined administration of RapidRhino and epinephrine might reduce the time spent in emergency departments by epistaxis patients.

Key words: Epistaxis; Hemostasis; Emergency treatment; Anticoagulants