Answer
Answer
Patients with respiratory compromise may first require airway control and mechanical ventilation. Patients with hemodynamic compromise may first require volume and blood product resuscitation.
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Media Gallery
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Nasal speculum.
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Nasal vascular anatomy.
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Lidocaine 2%.
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Epinephrine 1:1000.
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Epistaxis tray.
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Frazier suction tip.
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Bayonet forceps.
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Silver nitrate sticks.
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Merocel nasal packing with airway, 8 cm.
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Rapid Rhino anterior balloon tampon.
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Smaller Merocel epistaxis pack.
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Anterior nasal pressure with joined tongue depressors.
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Packing in place.
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Nasal packing with bayonet forceps and ribbon gauze.
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Patient sitting in an inappropriate, reclined position.
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Patient sitting in an appropriate, upright position.
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Patient with a history of significant left-sided epistaxis. Packing was performed in the emergency department with continued bleeding. After packing removal, small vessel arterial bleeding was noted on the anterior septum. Silver nitrate cautery is applied and dressed with dissolvable microfibrillar collagen. Video courtesy of Vijay Ramakrishnan, MD.
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