RCH logo
Victorian Government caretaker period

As the Victorian State election will be held on Saturday 28 November 2026, the Victorian Government will assume a Caretaker role from 6pm on 3 November 2026. During the caretaker period, content will only be added to this website in accordance with the Caretaker Conventions. See Guidelines for Caretaker Conventions.

Primary Care Liaison

Epistaxis - pre-referral

  • This pre-referral guideline covers Epistaxis in children from 1-16 years of age.

    Initial work-up

    • History and physical examination
      • Rule out allergic rhinitis.
    • If suspecting  blood dyscrasia
      • Through history (i.e. bruising, bleeding).
      • Family history.
    • Blood tests - (PT, APTT) if indicated by history

     

    Pre-referral treatment

    • Trial of antibiotic/steroid ointment to anterior septum 2x a day for 2 weeks
    • Observation of side
    • Acute bleeding usually settles with local pressure to the lower nasal septum

     

    When to refer

    • Not responding to conservative management i.e. no nose picking , strong nose blowing, application of topical nasal steroid
    • Epistaxis that is severe or occurs frequently
    • Attach blood tests results if done
     Referral form Referral form (Word)   
     Parent handout  Parent handout (pdf)

     

    Resources

    Kids Connect (RCH Primary Care Liaison)

    Kids Health Info (Parent factsheets online)

    Goto top

     

      Contact information                 

    Clinical advice

    		  

    Switchboard - ask for ENT specialist
    consultant or registrar on-call:

    		 (03) 9345 5522

    RCH Emergency Department:

    		 (03) 9345 6477


    Outpatients

    		  
    Booking enquiries & 
    appointment rescheduling     (Parents)    		 (03) 9345 6180 
    Rural doctors only (03) 9345 6789 


    Admission enquiries

    		  
    General admission enquiries: (03) 9345 6172

    ED admission enquiries:

    		 (03) 9345 6477

    After hours / Switchboard:

    		 (03) 9345 5522


    Other

    		  
    Seriously unwell child: (03) 9345 7007

    RCH Drug info-line:

    		 (03) 9345 5208

     

    References

    Paediatric Handbook(2009)Ear, Nose and Throat Conditions, Chapter 21 (pp312-324);Robert Berkowitz and Michael Marks;Eighth Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia

    Copyright and Disclaimer

    Goto Top