Perhaps few medical emergencies are as dramatic as epistaxis. Nothing will quite clear the way so quickly to the examining room, and no other "walk in" patient so often requires hospitalization. There are 2 provocative articles in the March issue of the Archives of Otolaryngology on the subject.1,2 Statistics gathered over a 10-year period from the Los Angeles County General Hospital are sobering. These reveal a mortality in severe epistaxis of better than 13% from all causes; none of these exsanguinated as a result of their epistaxis, but 3 patients died from aspiration of blood. The group with the highest mortality was the hypertensives wherein 98 out of 603 died. This emphasizes the fact that epistaxis in hypertensives connotes a serious prognosis.
The review of epistaxis by these articles is replete with anatomy, evaluation of the causes, and treatment. Little's or Kiesselbach's area, because of its anatomical location, is