Letters Epistaxis

Ice in the mouth for epistaxis

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e2573 (Published 10 April 2012) Cite this as: BMJ 2012;344:e2573
  1. Joseph G Manjaly, core surgical trainee year 2, ENT1,
  2. Kasia Konieczny, specialist trainee year 3, ENT1,
  3. N Julian Holland, consultant ENT surgeon1
  1. 1Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY, UK
  1. joemanjaly{at}doctors.org.uk

The recent article on epistaxis by Mulla and colleagues covers a simple condition that can be fatal.1 The authors suggest that placing ice packs on the nose can stop further bleeding. Despite this method being widespread, evidence suggests that application of ice packs to the nose or the neck (also common) has little effect on blood flow to the nasal mucosa.2

Ice placed in the mouth, however, decreases nasal mucosal flow by as much as 23%.3 We suggest that this is a more effective and evidence based method for stopping further bleeding and find it to be an effective adjunct for more posterior bleeds while definitive treatment is planned. Children can be encouraged to suck on flavoured ice lollies.


Cite this as: BMJ 2012;344:e2573


  • Competing interests: None declared.