Patients commonly present to the Emergency Department with epistaxsis (nose bleed). Standard first aid measures such as applying pressure can often stem bleeding however in more severe cases of epistaxsis further treatment is required. These treatments range from the use of vasoconstrictors to cauterisation and eventually to nasal packing.
It is well documented that patients who require nasal packing find this procedure uncomfortable and painful despite its ultimate effectiveness. The NoPac trial is investigating the novel use of tranexamic acid* (TXA) to reduce the need for nasal packing. Recruited participants will receive application of TXA or a placebo before nasal packing is considered. Identifying an effective alternative to this procedure would provide clear patient benefits.
EMERGE hope to commence recruitment to NoPac in spring 2017.
*TXA is a drug that has a good evidence base for the treatment of haemorrhage in trauma. EMERGE is currently involved in two other clinical trials of TXA,
Evaluating the role of early CT Coronary Angiography on patients with suspected or confirmed Acute Coronary Syndrome.
Evaluating the role of early CT Coronary Angiography
The Emergency Medicine Annotated Bioresource Consortium (EM-ABC): A pilot and feasability programme
Developing a bioresource for all emergency presentations
This trial is a two arm, multicentre parallel group, randomised controlled, open label trial comparing intravenous levetiracetam to intravenous phenytoin for the treatment of convulsive status epilepticus (CSE) in children, young people and young adults.
Emergency Treatment with Levetiracetam or Phenytoin in Status Epilepticus in Children (EcLiPSE) – an open label randomised controlled trial