ENT - Nosebleeds Flashcards
What are nose bleeds also known as?
Epistaxis
Where does epistaxis originate?
Kiesselbach’s plexus
AKA Little’s area
(Nose picking by little fingers)
What can cause epistaxis?
Nose picking
Colds
Vigorous nose blowing
Trauma
Weather changes
What causes haematemesis in epistaxis?
Swallowing blood during a nose bleed
What do bilateral nosebleeds indicate?
Bleeding posteriorly
Usually unilateral
How are nosebleeds managed?
Usually resolve without intervention
Recurrent and significant nosebleeds may need investigations to look for underlying causes
- Sit up and tilt head forwards
- Squeeze soft part of nostrils for 10-15 minutes
- Spit any blood in mouth out
What underlying causes do investigations for nosebleeds look for?
Thrombocytopenia
Clotting disorders
When is hospital admission necessary for nosebleeds?
Does not stop after 15 minutes
Nosebleed is severe
Bleeding from both nostrils
Unstable
How are more serious nosebleeds treated?
Nasal packing using nasal tampons or inflatable packs
Nasal cautery using silver nitrate sticks
What should you consider prescribing after treating a nosebleed?
Naseptin
(chlorhexidine and neomycin) 4x daily for 10 days
Reduces crusting, inflammation and infection
When can Naseptin not be used?
Peanut or Soya allergy
