Efficacy of ice packs in the management of epistaxis There are no uniformly accepted criteria for the management of epistaxis. The usefulness of ice application in the treatment of epistaxis as a first aid method is not generally accepted, but is widespread. In order to evaluate the effect of cold application on the blood vessels of the nasal mucosa, their blood flow and blood content were investigated on 56 healthy volunteers before and after exposure to cold in the neck area. Nasal mucosal microcirculatory blood flow was measured directly by non-invasive laser Doppler flowmetry in Kiesselbach's area. Changes in the nasal mucosal blood content were estimated using a conventional computer-aided rhinomanometer by measuring alterations in nasal airflow. After ice application in the neck area, no statistically significant effects on the blood vessels of the nasal mucosa were seen. These results do not support the usefulness of this manoeuvre in the treatment of epistaxis.