Re-bleeding post pack removal
Image 2 also shows 5 patients in loop one to have re-bled post pack
removal. Of these, 3 immediately bled, one re-presented at 12 hours and
one represented at 24 hours. 3 of these patients had comorbidities
including hypertension and were on anticoagulants. 1 patient had nasal
polyps and the other was fit and well. In loop two, 7 patients had
re-bled of which 3 were on the outpatient pathway and 4 on the inpatient
pathway. 2 on the outpatient pathway had no significant comorbidities, 1
had ischaemic heart disease with valve replacement and therefore did not
meet the “Pack and Home” criteria. 4 inpatient re-bleeders had a
history of hypertension or were on anticoagulants.