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J Korean Soc Emerg Med > Volume 28(3); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(3): 248-254.
응급실에 내원한 비출혈 환자에서 Rapidrhino® 패킹의 효용성
김범준1, 권문오2, 양찬주2, 조인수1, 이기일2
1한일병원 응급의학과
2한일병원 이비인후과
Effectiveness of Rapidrhino® Packing in Patients Who Visited Emergency Room due to Anterior Epistaxis
Bumjoon Kim1, Moon Oh Kwon2, Chan Joo Yang2, In Soo Cho1, Ki-Il Lee2
1Department of Emergency Medicine, Hanil General Hospital, Seoul, Korea
2Department of Otorhinolaryngology, Hanil General Hospital, Seoul, Korea
Correspondence  Ki-Il Lee ,Tel: 02-901-3149, Fax: 02-901-3819, Email: mdlee1911@hanmail.net,
Received: January 6, 2017; Revised: January 12, 2017   Accepted: May 8, 2017.  Published online: June 30, 2017.
ABSTRACT
Purpose:
Although there are many treatment options for managing epistaxis, little is known about their outcomes in the emergency department (ED). In this study, we evaluated the management of epistaxis, especially comparing the efficacy between Rapidrhino® and Merocel®.
Method:
A retrospective review of patients with epistaxis visiting the ED between January 2010 and June 2016 was performed. Haemostatic properties of packs were initially measured in the ED, and after the removal of packs in the otorhinolaryngology clinic. Subgroup analyses were performed in a similar fashion for patients receiving and not receiving anticoagulants or the antiplatelet.
Results:
The initial success rates for Rapidrhino® and Merocel® were both high (90.3%, 86.3%, respectively). Rebleeding rates for Rapidrhino® and Merocel® were 41.4% and 56.3%, respectively. Overall, there was a significant difference between the two types of packs in recurrence (p=0.032). Particularly, in patients with anticoagulants, the initial success rates of Rapidrhino® were higher than that of Merocel® (88.6%, 76.2%, respectively, p=0.222). The rebleeding rate of Rapidrhino® was much lower than that of Merocel® (54.3%, 85.7%, respectively, p=0.016). In the Rapidrhino® group, the rebleeding rate varied according to the packing removal date (p=0.001).
Conclusion:
Rapidrhino® and Merocel® are equally effective in the initial arrest of epistaxis in the ED. Rapidrhino® may be more effective in controlling haemorrage on removal, particularly in patients with anticoagulants. Patients with epistaxis could be treated with Rapidrhino® in the ED, which could be removed in the outpatient clinic one day later.
Key words: Epistaxis, Hemostasis, Emergency treatment, Anticoagulants, Platelet aggregation inhibitors
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