Effect of practical demonstration to use nasal spray and apply intranasal ointment on outcome, in cases of recurrent idiopathic pediatric epistaxis in Combined Military Hospital, Mardan: A Randomized Controlled Trial

Abstract

Abstract

One of the most common Otorhinolaryngology emergency in pediatric population is epistaxis, usually arising from the Kiesselbach’s plexus.

Objectives

To compare the effectiveness of practical demonstration and educating epistaxis patient’s parents for applying intra nasal cream with number of epistaxis episodes at follow up as the outcome with those being just verbally educated.

Methods

We conducted a two arm parallel design (1:1), single blind randomized control trial in 300 newly diagnosed epistaxis patients reporting to ENT department of CMH Mardan between June 2018 to Dec 2018.

Interventions

Parents of randomly assigned epistaxis patients in the intervention arm were given practical demonstration and education for applying intra nasal cream and control arm patient’s parentswere given just the verbal education about cream application.

Primary outcome measure

The primary outcome was the overall treatment success rate (defined as reduction in number of epistaxis episodes at follow up) which was determined and compared in the two arms using Chi square analysis.

Results

Between June and Dec 2018, a total of 310 epistaxis patients were screened and 300 were randomized. At the analysis stage 148 patients were in the intervention arm as compared to 147 in the control arm. A significant difference between the intervention and control arm was seen for the presence or absence of epistaxis, with the intervention arm showing much better results (p= <0.001).

Conclusion

This study shows practical demonstration along with verbal education is an effective strategy to treat recurrent idiopathic epistaxis patients. Giving practical demonstration at the start of treatment is thus recommended.