Epistaxis for the ENP

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Epistaxis for the ENP

• Dave Pothier
• ENT SpR
• RUH

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Blood supply

• Internal
• External

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A B C
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First aid

• Definitely
• Pinch over littles area at least 20 mins with
  zeroing with each release
• Sit forward
• Rest
• Possibly
• Ice on neck
• Ice over nose/forehead
• Ice in mouth

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AgNO3 Cautery

• Top tips
• Get comfortable
• Get patient comfortable
• Anaesthetise well
• Have the right gear
• Know how to use it

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Nasal packs
First aid Merocel/RapidRhino Anterior packing
with BIPP Posterior packing with BIPP
catheter
Skill required morbidity
effectiveness
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Naseptin

• Antibiotic
• neomycin sulphate
• Antiseptic
• chlorhexidine hydrochloride

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Bilaterally, BD, 2/52
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Before discharge

• Deal with usual social issues
• No heavy activities
• No hot meals or baths
• No nose blowing douche only
• Do NOT stop asprin
• Explain proper first aid

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What can we do?

• Posterior packing
• EUA Nose cautery
• SPA Ligation
• Anterior ethmoid artery ligation
• External carotid artery ligation

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SPA Ligation