What is the clinical presentation of anterior nasal packing for epistaxis?

Updated: May 09, 2018
  • Author: Eric Goralnick, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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As with any unstable patient, initial management begins by assessing airway, breathing, and circulation (the ABCs). Next, the source of the bleeding should be identified. The source of most anterior bleeds can be identified using a headlight and adequate suction.

Once the bleeding point is identified, cauterization—either chemical (silver nitrate) or electrical (hotwire or bipolar cautery)—usually provides definitive treatment. [4] If cauterization is unsuccessful, anterior nasal packing is the next step.

Nasal packing is the placement of an intranasal device that applies constant local pressure to the nasal septum. Nasal packing works by (1) direct pressure; (2) consequent reduction of mucosal irritation, which decreases bleeding; and (3) clot formation surrounding the foreign body, which enhances pressure.

For more information, see Epistaxis, Management of Acute Epistaxis, and Posterior Epistaxis Nasal Pack.

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