Epistaxis

Question 1

What location of nose bleeds are there

Answer 1

Anterior - littlest area , kesselbachs plexus
Posterior - woodruffs plexus
Most happen in the anterior section

Question 2

What is the anastomoses at little’s area

Answer 2

Facial artery
Sphenopalatine
Anterior ethmoidal

Question 3

Causes of nose bleeds

Answer 3

Spontaneous

Trauma

Question 4

What is the first thing you need to do before you approach management of a nose bleed

Answer 4

G up
Gown
Goggle
Gloves

Question 5

What is the assessment you need to do if the patient

Answer 5

A-E

Question 6

Important to ask in hx

Answer 6

Which side 
trauma
How much loss
On warfarin/aspirin
Pmh

Question 7

What is the first step In management

Answer 7

Sit forward
Hold the nose for 20 mins at the tip of nose
Ice to the bridge also suck on an ice cube
Spit blood into bowl

Question 8

What is the second thing to do it not stopped

Answer 8

Prepare to cauterise
Remove clots - blow or suck
Use vasoconstrictor adrenaline up the nose 2 mins
Make sure that you dry the nose
Finds bleeding points apply cautery for 2 secs

Question 9

What should you never cauterise

Answer 9

Both sides of the nose /nasal septum cos you can cause perforation

Question 10

3rd thing to do after the nose doesn’t stop bleeding

Answer 10

Anterior nasal pack - rapid rhino , merocel

If still bleeding 24hrs after
Post nasal pack - Foley catheter
P

Question 11

What to do when you can’t find the bleeding point

Answer 11

Refer to ent