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. 2021 May 4;13(5):e14832. doi: 10.7759/cureus.14832

Table 4. Gray literature study characteristics and findings.

Author, year, country Study design, setting/audience Intervention concepts Cryotherapy statements Direct pressure application time
Pope and Hobbs, 2005, United Kingdom [16] Narrative: Clinical practice Direct pressure; Patient position; Cryotherapy “... improved by a cold compress or the patient sucking on ice.” p. 310 NA
Wong and Anat, 2018, Australia [34] Narrative: Family practice Direct pressure; Patient position; Cryotherapy “Applying ice packs around the neck and having the patient suck on ice significantly reduces nasal mucosa blood flow and can slow down the bleeding.7” p. E16 10 min
Record, 2015, United States [35] Practice guideline: Nursing Direct pressure; Patient position; Cryotherapy “Ice compresses to the forehead or neck may be used, but studies are inconclusive as to the usefulness of this maneuver (Teymoortash 2003; Scheibe, 2006).” p. 487 10 min
Upile et al., 2008, United Kingdom [17] Protocol: United Kingdom Healthcare System, first aid Direct pressure; Cryotherapy “… pinching the whole of the cartilaginous tip of the nose for 30 min followed by another 30 min of pressure and pack of ice on bridge of nose if bleeding continued.” p. 1351 30 min + 30 min
Epistaxis, 2020, N/A [36] Informational: Website Direct pressure; Cryotherapy “… putting an ice pack on to their forehead.” p. N/A 20 min
Beck, 2018, German [4] Review: Primary and secondary care Direct pressure; Patient position; Cryotherapy “Local application of ice, e.g., at the back of the neck, is intended to encourage vasoconstriction of the blood vessels of the nose.” Its therapeutic value is a matter of debate and has been challenged in the literature (38).” p. 17 15-20 min