1 / 9

Nasal Emergencies and Sinusitis

Nasal Emergencies and Sinusitis. Chapter 241. Blood supply and anatomy. Anterior Epistaxis. 90% of nosebleeds (picking zone) Keisselbach’s plexus Treat Direct pressure Vasoconstrictive agents Nasal packing (antibiotics) Cautery. Posterior Epistaxis. More profuse bleeding

buthainah
Download Presentation

Nasal Emergencies and Sinusitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Nasal Emergencies and Sinusitis Chapter 241

  2. Blood supply and anatomy

  3. Anterior Epistaxis • 90% of nosebleeds (picking zone) • Keisselbach’s plexus • Treat • Direct pressure • Vasoconstrictive agents • Nasal packing (antibiotics) • Cautery

  4. Posterior Epistaxis • More profuse bleeding • Elderly with htn and atherosclerosis of sphenopalatine arteries • Consider admission especially with cardiac or respiratory comorbidities • May require urgent ENT consult • Reverse coagulation

  5. Posterior Packings

  6. Nasal Fracture • Swelling, tenderness, crepitance, ecchymosis, and deformity • Not required to get xray • When swelling resolves, refer to ENT/plastics • R/O septal hematoma • Consider other facial fx, cribiform plate fx with CSF leakage and spinal injuries…CT

  7. Nasal Foreign Bodies • Sensation of unilateral nasal obstruction • Persistent, foul-smelling rhinorrhea • Persistent unilateral epistaxis • Remove • Positive pressure technique • Curette • Suction

  8. Sinusitis • Six nasal sinuses • Occurs due to acute obstruction of normal drainage • Viral most common • Bacteria: Strep pneumo, H. flu, M. cat • Acute >7 days <3 wks of symptoms • Chronic >3 wks

  9. Sinusitis Continues • Purulent nasal secretions • Dull aching sinus/facial/dental pain • Routine radiography not recommended • CT if differential unclear or to r/o complications • Bony destruction, abscess, cavernous thrombosis • Antibiotics if sx >7days • Amoxicillin or Bactrim (acute) • Nasal spray and decongestants/antihistamines

More Related