1. Epistaxis
Prof Mulder
2012
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2. IT IS ALWAYS A SYMPTOM OF PATHOLOGY !!
IT IS NEVER A ”DISEASE”
IT IS ALWAYS A SYMPTOM OF PATHOLOGY !!
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3. Congenital etc…….
LOCAL
SYSTEMIC

4. TREAT THE CAUSE VASCULAR Rx CONGENITAL INFECTIVE INFLAMMATION NEOPLASM
TRAUMA
ALLERGY
AUTO - IMMUNE
VASCULAR
ENDOCRINOLOGY
METABOLIC
MECHANICAL
MEDICATION
TREAT THE CAUSE

5. WALL CONTENTS Cells: (Rbc. Wbc. Platelets Immunoglobulins Electrolytes
Clotting factors
Glucose
Cholesterol
etc..

6. EPISTAXIS
HYPERTENSION
DISPRIN, GRANDPA
HEADACHE

7. LITTLE‘S AREA Pressure Ice pack Plug with cottonwoolRx
LITTLE‘S AREA
Pressure
Ice pack
Plug with cottonwool
( + vasoconstrictor)
Cauterize

8. Rx
POSTERIOR EPISTAXIS
PACKING
Gauze tape
Merocel
+ Foleys catheter

9. Calm the patient
Explain what you are going to do
IV fluids
Blood transfusion
Blow the nose (+ suction)
Determine which side is bleeding
Pack the nose:
Anterior pack (BIPP, Merocel, Gauze tape)
Posterior pack (Foleys catheter)

10. DANGERS OF NASAL PACKS
No sedation!!!!!!!!
Hypoxia
Antibiotic cover essential
Patient to be admitted
Trauma to nasal vestibule

11. WHY (HOW) DO THESE CONDITIONS CAUSE EPISTAXIS?
Arteriosclerosis
Hypertension
Cardiac failure
Diabetes
Uraemia
Liver cell failure
Drugs
Leucemia