An interventional study of Nurse-Delivered First-Aid Education and Usual Care in Epistaxis and Recurrent Epistaxis, sponsored by Cairo University. Completed at 1 site in Egypt. Open to participants aged 3 Years and older. Per ClinicalTrials.gov, last updated 2026-10-27.
Sponsored by Cairo University · Not applicable, Interventional, and Supportive care
Nosebleeds (epistaxis) are common in children and can cause anxiety for children and their caregivers. Although most nosebleeds can be managed at home using simple first-aid techniques, caregivers may not know the correct steps to stop bleeding or prevent repeated episodes.
This randomized controlled trial evaluated whether a nurse-delivered first-aid education program could improve caregivers' knowledge and practical skills and reduce recurrent nosebleeds and related healthcare visits among children aged 3-14 years.
The study involved 144 caregiver-child pairs at a tertiary hospital in Al-Ahsa, Saudi Arabia. Participants were randomly assigned to one of two groups. The intervention group received an individual nurse-led education session lasting approximately 40-45 minutes, practical demonstrations and teach-back exercises, illustrated Arabic educational materials, and two follow-up telephone calls at weeks 2 and 6. The comparison group received usual medical care and advice.
Caregivers' first-aid knowledge and skills were assessed at the beginning of the study and again at 4 and 12 weeks. The main outcome was caregivers' ability to correctly demonstrate nosebleed first aid at 12 weeks. Other outcomes included first-aid knowledge, the number and duration of nosebleeds, whether bleeding could be stopped at home within 15 minutes, and unplanned healthcare visits.
The study aimed to determine whether a brief, structured nursing education program could help families manage recurrent childhood nosebleeds more effectively.
Background and Rationale
Recurrent anterior epistaxis is a common problem in childhood and can cause distress, interfere with family activities, and lead to unplanned healthcare visits. Effective first aid involves positioning the child upright, leaning slightly forward, and applying continuous pressure to the soft part of the nose. However, caregivers may use ineffective techniques, such as tilting the child's head backward or repeatedly releasing pressure. Structured education using demonstration, return demonstration, and teach-back may improve caregivers' ability to manage bleeding episodes safely.
Study Objective
The study evaluated the effectiveness of a structured nurse-delivered first-aid education program, compared with usual care, in improving caregivers' practical first-aid skills and knowledge and reducing recurrent epistaxis and related healthcare use among children.
Study Design and Setting
This was a two-arm, parallel-group, assessor-blinded, superiority randomized controlled trial with a 1:1 allocation ratio and 12-week follow-up. The study was conducted in the otorhinolaryngology outpatient clinic and pediatric emergency department of a tertiary hospital in Al-Ahsa, Eastern Province, Saudi Arabia.
A total of 144 caregiver-child pairs were randomized, with 72 assigned to the intervention group and 72 to the usual-care group. Allocation was based on a computer-generated randomization sequence using randomly varying block sizes of four and six, stratified by child age (3-7 years and 8-14 years). Sequentially numbered, opaque, sealed envelopes were used for allocation concealment. Outcome assessors were blinded to group assignment, although caregivers and intervention nurses could not be blinded.
Participants
Eligible participants were caregivers aged 18 years or older of children aged 3-14 years with recurrent anterior epistaxis, defined as at least three reported episodes in the preceding three months, with an anterior bleeding source confirmed by clinical examination. Caregivers were required to communicate in Arabic, have access to a mobile telephone, and reside in the Al-Ahsa region.
Intervention
The educational intervention was based on self-efficacy theory and the teach-back approach. It consisted of an individual 40-45-minute education session, practical demonstration and return demonstration of correct first-aid techniques, a two-page illustrated Arabic leaflet, a refrigerator reminder magnet, and telephone reinforcement at weeks 2 and 6.
Education covered common causes and triggers of childhood nosebleeds, correct positioning, continuous nasal compression, harmful practices to avoid, preventive measures, aftercare, and warning signs requiring medical attention. Caregivers practiced the techniques with feedback until they could demonstrate the required steps correctly.
Participants in the control group received usual otorhinolaryngology care, including standard physician advice and any clinically indicated treatment. Control caregivers were offered the educational materials and session after the final assessment.
Outcome Assessment
Measurements were obtained at baseline, 4 weeks, and 12 weeks. The primary outcome was the caregiver's observed first-aid skill score at 12 weeks, measured using a 10-item checklist with a total score ranging from 0 to 20, where higher scores indicated better performance.
Secondary outcomes included first-aid knowledge scores, first-aid skills at 4 weeks, the number of recurrent nosebleed episodes, episode duration, the proportion of episodes controlled at home within 15 minutes, and unscheduled epistaxis-related healthcare visits during the 12-week follow-up.
Caregivers recorded bleeding episodes and related healthcare use in structured diaries. Healthcare visits were additionally checked against available clinical records. Potential adverse events related to first-aid management were monitored throughout follow-up.
Statistical Approach
The primary comparison was planned using analysis of covariance, adjusting for baseline skill score and the child-age randomization stratum. Recurrent episode counts and healthcare utilization were analyzed using regression models appropriate for count outcomes. Analyses followed the intention-to-treat principle, with sensitivity analyses to assess the robustness of the findings.
96 studies on the registry are indexed under Epistaxis; 22 are open to participants now.
This study's enrollment of 144 is above the median of 64 across 81 interventional studies indexed under Epistaxis.
Browse Epistaxis studies →Cairo University is the lead sponsor of 4,941 studies on the registry; 1,458 are open to participants now.
Of its 37 completed or terminated interventional studies of FDA-regulated products, 5 (14%) have results posted.
Counted across the registry records on this site, refreshed daily.
**Inclusion Criteria:**
**Exclusion Criteria:**
When more than one caregiver accompanied an eligible child, the family nominated the caregiver most frequently present during nosebleed episodes.
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Platelets
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants assigned to this arm received Nurse-Delivered First-Aid Education in addition to usual clinical care. The intervention included an individual 40-45-minute nurse-led educational session covering childhood epistaxis, correct first-aid techniques, preventive measures, and indications for seeking medical attention. Caregivers participated in practical demonstrations, return demonstrations, and teach-back exercises. They also received an illustrated Arabic leaflet, a reminder magnet, and reinforcement telephone calls at weeks 2 and 6. Participants were followed for 12 weeks.
Behavioral: Nurse-Delivered First-Aid Education · Other: Usual Care
Participants assigned to this arm received Usual Care for recurrent childhood epistaxis, including routine otorhinolaryngology assessment, standard physician advice, and clinically indicated treatment. They did not receive the structured nurse-delivered educational session, practical teach-back training, illustrated educational package, or scheduled reinforcement telephone calls during the 12-week follow-up. The educational materials and session were offered after the final assessment.
Other: Usual Care
A structured caregiver education program delivered individually by a trained nurse. The intervention consisted of one 40-45-minute face-to-face educational session covering the causes and triggers of pediatric epistaxis, correct positioning, continuous compression of the soft part of the nose, preventive measures, and warning signs requiring medical attention. The session incorporated demonstration, return demonstration, and teach-back. Caregivers received a two-page illustrated Arabic leaflet and a refrigerator reminder magnet. Two reinforcement telephone calls were provided at weeks 2 and 6. The intervention was delivered alongside usual clinical care.
Routine clinical management for recurrent pediatric epistaxis provided through standard otorhinolaryngology services. Care included clinical assessment, standard physician advice, and any treatment considered necessary by the treating clinician. Participants did not receive the structured nurse-delivered first-aid education program or its scheduled reinforcement components during follow-up.
Caregiver First-Aid Skills Score at 12 Weeks
Caregivers' ability to perform correct first aid for pediatric epistaxis was assessed using the Epistaxis First-Aid Skills Checklist during a standardized scenario with a pediatric manikin. The checklist contains 10 actions, each scored 0 (not performed or incorrect), 1 (partly correct), or 2 (fully correct). Total scores range from 0 to 20, with higher scores indicating better first-aid performance. The primary comparison was the 12-week score between the intervention and control groups, adjusted for baseline skill score and child age stratum.
Time frame: 12 weeks after randomization
Title: Caregiver First-Aid Knowledge Score
Description: Caregiver knowledge of pediatric epistaxis first aid was measured using the 20-item Epistaxis First-Aid Knowledge Questionnaire, covering causes, prevention, first-aid steps, harmful practices, afte
Time frame: Baseline, 4 weeks, and 12 weeks
Caregiver First-Aid Skills Score at 4 Weeks
Caregiver first-aid performance was assessed using the 10-item Epistaxis First-Aid Skills Checklist in a standardized manikin-based scenario. Each action was scored from 0 to 2, yielding a total score of 0 to 20. Higher scores indicate better performance.
Time frame: 4 weeks after randomization
Plan to share: No
Ran from Jul 2026 to primary completion in Sep 2026, 1 month.
Of 24 interventional studies with no phase under Epistaxis, half reached primary completion within 14 months of starting (the median), counting those still running; a quarter within 3 and three quarters within 25. This study's 1 month is below that.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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