Epistaxis Management

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This module describes how to

that does not resolve with direct pressure.




Always verify your patient’s identity and obtain informed consent before proceeding.

How do I explain this procedure?

“I’m going to try different ways to stop your nose bleeding.”

What can my patient expect?

“We will first try to stop the bleeding by pinching your nose for 15 minutes. If it doesn’t work, I will try to find the bleed and stop it with a chemical. This will be uncomfortable, but it will not burn you. If I can’t stop the bleed this way, I will need to pack your nose tightly with gauze and perhaps even a small balloon. This will be very uncomfortable for you, but this kind of bleed must be stopped. You may need to stay in hospital overnight.”

What is my patient’s role?

“Tell me if you have any allergies, take blood thinners, or have

. Let me know if you have severe pain or dizziness at any point.”


Prepare a trolley with equipment.

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Documentation

Equipment


Position the patient sitting upright.

Most epistaxis originates in the anterior nasal cavity, and most anterior epistaxis originates from Kiesselbach’s plexus.

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Follow medical asepsis with non-sterile gloves.


The patient is uncooperative.

Try to reassure the patient, and explain why this is necessary. You may need an assistant to help with restraining.

I don’t have access to a Rapid Rhino and the patient is still bleeding.

Remove the anterior pack. Place a

by feeding a Foley catheter through the nostril until it is visible in the oropharynx. To avoid gagging, advance no further. Inflate the balloon with 5 ml of water, then retract it until it is firmly wedged in the posterior nose. Inflate with another 5 ml water. Wrap the catheter in gauze where it exits the nose and secure it to the face with tape. Subsequently, place an anterior pack.

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