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Managing Epistaxis in Clinical Settings

Understand key sites of bleeding in epistaxis, common causes, and effective management strategies. Learn about the nasal septum and nasal cavities' rich blood supply, along with the impact of hypertension on bleeding control. Discover proper and incorrect management techniques for immediate intervention.

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Managing Epistaxis in Clinical Settings

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  1. EPISTAXIS Dr Gary Kroukamp

  2. Sites of bleeding • Nasal Septum - Little’s Area ~90% of epistaxis seen in hospitals ~vessel often visible - Rest of septum ~spurs, convexities (turbulent flow)

  3. Sites of bleeding

  4. Nasal cavities - blood supply Rich supply from 2 branches of Common Carotid: • Ext. Carotid - maxillary a. - most • Int. Carotid - ethmoidal aa.- roof

  5. Osler-Weber-Rendu

  6. HYPERTENSION • Is NOT a cause but contributes • Once epistaxis has occurred, it is more difficult to control in the presence of: - hypertension - tachycardia - raised venous pressure

  7. Management – immediate • Position • Pressure • Pulse / BP • Cautery • Packing

  8. 5 minute pressure

  9. Incorrect

  10. Management - immediate • Cautery - clear nose - suction -“hawk” - inspect - bleeding vessel - local / vasoconstrictor (cocaine) - cauterise - AgNO3 - electro-

  11. Packing - anterior • local anaesthetic • BIPP impregnated gauze in layers

  12. Packing - posterior • Inflatable balloons • Saline better than air

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