9th April 2020

Musgrove research study could transform way serious nose bleeds are treated

Musgrove Park hospital’s emergency department has opened a new clinical research study which could transform patient experience of the way serious nose bleeds are treated.

Taunton and Somerset NHS Foundation Trust is one of 14 hospital trusts across England and Scotland now recruiting patients to the NoPac study.

NoPac principal investigator at Musgrove and consultant in emergency medicine, Dr Jason Louis, said:

“Nobody likes to have to come to us with a nosebleed but the patients who help with this research trial will help clarify the most efficient way to treat nosebleeds in the future.”

Dr Louis thanked the emergency department staff team for their hard work in running research studies and Musgrove Park patients for taking part in trials which inform and improve clinical practice.

NoPac is trialling the novel use of Tranexamic Acid to reduce the need for nasal packing to treat acute spontaneous nose bleeds. The National Institute for Health Research awarded funding through its Research for Patient Benefit Programme.

Dr Louis explained:

“Epistaxis or nose bleeds are an extremely common condition caused by a blood vessel bursting within the nose as a result of trauma or spontaneously. Patients who come to hospital emergency departments are frequently elderly.

In most cases the bleed can be resolved by simple measures like applying firm pressure with the thumb and index finger to the soft anterior or front part of the nose, the use of ice packs on the bridge of the nose and by leaning forward. If bleeding cannot be stopped patients attending hospital emergency departments usually undergo anterior nasal packing which is an extremely uncomfortable experience and can require a hospital stay for several days.

There can also be complications from nasal packing including infection, sleep apnoea and bleeding on removal of the packing. This procedure is tolerated only on the basis that there is at present little alternative ways to treat it.”

He added:

“Tranexamic acid (TXA) has been used in a variety of clinical and research settings to stabilise and stem blood clotting.

Results from a local study suggested that TXA could provide a promising alternative treatment to the current nasal packing practice and greatly enhance the experience for patients in the future.”