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Chicago, IL


Procedure: Acute Epistaxis management

Monitors: Pulse ox

IV access: Yes

Suction: Yes

Patient was sat in upright position with head slightly tilted forward, acute bleeding was noted from left/right/bilateral nares. Patient was educated on proper pressure application anteriorly and after 5-20 minutes, this failed to control epistaxis.Under proper lighting and after clearing nares, no foreign body was noted and bleeding site localized to the ______. 

  • Pledgets soaked in oxymetazoline or  4% cocaine were packed into ___ nare and anterior pressure was held with/without resolution of bleeding after removal. 
  • Silver nitrate cautery was then applied directly to bleeding site after lidocaine topicalization with/without resolution of bleeding. 
  • The anterior ____ nasal cavity was then packed with merocel/rhino rocket/ribbon gauze along the floor of the nasal cavity with/without resolution of bleeding. 

Patient was observed for 30 minutes without evidence of ongoing bleeding. Patient remained hemodynamically stable during the entire procedure. No complications. 

Discharged with anterior/posterior packing in place. Patient commenced on anti-staphylococcal antibiotic while packing remains in place.