Epistaxis Flashcards
what is Little’s area
seen on the anterior portion of the nasal septum using thuddicums speculum
what area accounts for 85% of all epistaxes
Little’s area
what is Kiesselbach’s plexus
the plexus of vessels in Little’s area: formed by 3 arteries
what 3 arteries form Kiesselbach’s plexus?
- anterior ethmoidal
- sphenopalatine
- greater palatine
management if there is a visualised bleeding point
cauterise
management if there is not a visualised bleeding point
put an anterior pack in
management if there is continuous bleeding despite an anterior pack inserted
posterior pack
management following controlled bleeding with either an anterior pack or posterior pack?
ward admission for follow up
advice to patients following an epistaxis
- do not blow nose for a week
- do not clean the nose
- avoid hot baths/showers
- let food cool down
- do not drink hot drinks fro first 72 hours
- no strenuous exercise for a week
ointment following an epistaxis, and duration
Naseptin BD for 1-2 weeks –> to keep nasal cavity lining free of crusts and kept moist
what is the cautery used
silver nitrate
how long can posterior packs stay in for without giving abx
48 hours
what should be given if a posterior pack is required to be kept in for longer than 48 hours
prophylactic oral Abx
3 investigations for a patient with epistaxis?
- bloods: FBC, group + save, coag profile
- ensure IV access available
- examine nose w/ thuddicums speculum
most common cause of epistaxis
trauma
3 medications in the elderly that can increase risk of epistaxis
- warfarin
- aspirin
- clopidogrel
nasal pathology risk factors for epistaxis
- Sinonasal malignancy
- SCC in post nasal space
cause of nasal vestibule inflammation that could cause epistaxis
staphylococcal colonization
creams than can reduce inflammation of nasal vestibule through antibacterial properties
naspetin
or
bactroban
haematological causes of epistaxis
ITP
+
DIC
iatrogenic cause of epistaxis
recent nasal surgery
inflammatory causes of epistaxis
GPA
+
Sarcoidosis
trauma causing epistaxis
blunt trauma or nose picking
neoplasm of nasal cavity causing epistaxis
- SCC
- Adenocarcinoma
- inverted papilloma
