MSRA-0613

MSRA-0613

A 45-year-old businessman presents to the Emergency Department with his second episode of epistaxis in a 24 hour period. On each occasion, the nosebleeds stopped with pressure applied just below the nasal bridge, but the most recent bleed went on for 30 minutes. He has hypertension, for which he takes medication regularly. He also admits to smoking a pack of cigarettes per day and drinking 10-15 units of alcohol each week. There is no history of trauma. He is worried about the problem affecting his work, as he has an important meeting the following day.
On examination, he looks well and is not pale, and his blood pressure and pulse are within normal limits. He is peripherally well perfused. On inspection of the nasal vestibule, there are prominent blood vessels visible on the right side of the nasal septum, with a small amount of clotted blood also present.
What is the most appropriate management plan for this patient?