Any of the following is acted on immediately. EMS is activated first for life threats; provider notification and orders follow.
Red flags — act immediately
Epistaxis not controlled by sustained firm pressure, or a large-volume or posterior bleed → continue pressure and activate EMS; the threshold is lower on an anticoagulant or with severe hypertension (cross-reference Anticoagulation, Hypertension).
Bleeding with light-headedness, pallor, or hemodynamic change → activate EMS.
A nasal-cannula pressure injury of the nares, columella, or behind the ears → offload and treat; notify (cross-reference Wounds).
Facial swelling and redness from a sinus source, with fever → possible facial cellulitis; notify urgently.
New unilateral obstruction with bloody drainage or a mass → evaluate; notify.
Nasal trauma with deformity or significant bleeding → control bleeding and notify for evaluation.
