Week 4 - Wound care Epistaxis

Question 1

what is anterior epistaxis?

Answer 1

95% of all bleeds, atraumatic, littles area or kiesselbach, compressable and unilateral

Question 2

what is posterior epistaxis?

Answer 2

5% of bleeds, post nasal drip, profuse and not compressable, woodruff plexus- both nostrils

Question 3

what is the managment of anterior epistaxis?

Answer 3

first aid - 20 minutes of direct pressure
ice
lean forward to help with drainage

Packing - rapid rhino, merocel, impregnated gauze, absorbant aterial, heamostatic agents

Cauterisation- silver nitrate, electro diathermy

Question 4

How do you pack an anterior epistaxis?

Answer 4

clear nose- cough, blow, suction
clear explantation- examine - see from kissleback area

procedure
sitting upright, tilt nose, co-phenicaine spray
pack
grasp firmly- push flat and firm along floor of turbinates
consider bilateral packing if still bleeding

Question 5

what is done with posterior packing?

Answer 5

heamorrage control
urinary catheter 14-20 Fg
insert aling floor of nose
insert balloon to oropharynx, pull untill resistence, can pack with gauze and catheter

leave pack in situ and referall for surgury

Question 6

how do you cauterise with silver nitrate?

Answer 6

silver nitrate

direct 1st lin mx 2nd after pack removed cauterisation of littles area

Question 7

what tools are needed for cauterisation?

Answer 7

spectulam, light, antiseptic