A Randomised Controlled Trial Comparing the Use of Foam Polymer Nasal Tampons and BIPP in the Control of Acute Epistaxis in Primary Care

Abstract

Objective: To compare the effectiveness, usefulness and acceptability of foam polymer nasal tampons (Merocel nasal tampons) to BIPP impregnated ribbon gauze in the management of acute epistaxis in ambulatory patients at primary care facilities.
Design: A randomised controlled trial.
Setting: Five private family practices, a community health centre and the general outpatient department of a referral hospital in the Cape Town Metropole.
Subjects: Ninety-nine cases, older than 14 years, presenting with acute epistaxis at these facilities.
Main outcome measures: Ease of introduction of nasal packing, comfort to patient, bleeding at IS and 30 minutes, side effects and complications, bleeding after removal. Results: The two methods were found to have similar effectiveness in stopping epistaxis at 30 minutes after insertion. Foam polymer nasal tampons were more painful and difficult to insert and caused more discomfort while in place. BIPP packs dislodged more easily. No serious side effects were found with either method.
Conclusions: The foam polymer nasal tampon is a safe, quick, relatively easy and reasonably effective method of controlling acute epistaxis in primary care patients. The cost of the foam polymer nasal tampon may limit its application in primary care practice.