Treatment of Nosebleeds in the Emergency Department With Powder Tranexamic Acid

Launched by DR. ANNE CONLIN · May 22, 2025

Keywords

ClinConnect Summary

This clinical trial is exploring a new way to treat nosebleeds, also known as epistaxis, in the emergency department. Nosebleeds are common and can sometimes be serious, requiring immediate medical attention. Currently, doctors often use methods like cauterization or nasal packing, which can be painful and carry risks of complications. The study is testing a new form of tranexamic acid, a medication that helps stop bleeding, which is sprayed directly into the nose. Researchers want to see if this new method can effectively stop nosebleeds without the discomfort and risks associated with current treatments.

To participate in this trial, you need to be an adult aged 18 or older and have an active nosebleed when you arrive at the emergency department. You should be able to provide informed consent and be willing to follow the study guidelines. However, certain conditions may prevent you from joining, such as recent nose surgery, bleeding disorders, or being pregnant. If you qualify and choose to participate, you will receive the tranexamic acid spray to evaluate its effectiveness in stopping your nosebleed. Your safety is a top priority, and the study team will monitor your experience throughout the trial.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Capable of giving informed consent form
• • Stated willingness to comply with all study procedures and availability for the duration of the study
• • Adults 18 years or older
• • Male or female
• • Presenting to the ED with active, spontaneous epistaxis. Anterior versus posterior epistaxis will be identified a priori. Anterior epistaxis is operationally defined as active nasal bleeding that occurs anterior to the anterior limit of the middle turbinate, visible by anterior rhinoscopy.
• Exclusion Criteria:
• • Prior sinonasal surgery within the preceding 1 month.
• • Patients who required medical treatment for epistaxis in the preceding 30 days.
• • Septum perforation.
• • Known history of bleeding disorders, including thrombocytopenia, hemophilia, hereditary hemorrhagic telangiectasia, or von Willebrand disease.
• • History of known thromboembolic disease, including subarachnoid hemorrhage, stroke, or TIA.
• • Known history of disease of the central nervous system, including seizures, convulsions, or intra-cerebral disease processes/lesions.
• • Known or suspected history of significant skull base trauma, including skull base fracture or cerebrospinal fluid leak.
• • Known history of acquired disturbances of colour vision.
• • Known hematuria or any bleeding related to the kidney.
• • Pregnant and/or lactating women.
• • History of known allergy or sensitivity to the study medication.
• • Presence of signs or symptoms of concomitant emergent conditions, including myocardial infarction, stroke, major trauma, shock, or hemodynamic instability.
• • Patients with other medical conditions including cognitive limitations or impairment due to substance abuse.
• • Patients with any other condition that, in the opinion of the investigator, may present an unreasonable risk to the patient, may make the patient unreliable, or may interfere with the study assessments.
• • Current participation in another interventional clinical trial.