| Disease |
EPISTAXIS |
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| Quotation |
“Panic for every little bleed from the nose, and you end up paying through the nose” |
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| Definition |
Haemmorhage from nostril, nasal cavity or nasopharynx. |
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| Prognosis |
Good with proper therapy. |
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| Treatment |
Ask the patient to sit up, and tightly pinch and clamp, full thickness of both nostrils for 5 minutes.
Ask him to breath through the mouth and spit our all the blood that come n the throat.
Keep ice cubes in a handkerchief over the nose.
Check B.P. if raised, Cap. DEPIN 10mg sublingual stat.
Inj. Calcium gluconate 10cc I.V slowly
Ink. Dicynene 1amp I.V. stat (Hemostatic drugs) or Inj. Strypto chrome 1 amp IM
Tab. Dicynene/ Stryptovit x 1 tds x 5 days.
Ask about H/o bleeding disorders in past or in family, Ask about bleeding from the other sites.
If yes, refer immediately to a Hospital with facilities for fresh blood transfusion.
If bleeding has not stopped by pinching the nose for 10 mins, then keep a adrenalin pack in each nostril.
Take 1 amp N. Saline + 1 amp adrenalin in a Bowl.
Wet 2 strips of gauze piece in it.
Insert 1 strop in each nostril, and pinch the nose again.
If bleeding does not stop, refer immediately to a ENT surgeon for nasal packing.
Inj. Calcium gluconate,
Ink. Dicynene 1amp
Inj. Strypto chrome
Tab. Dicynene/ Stryptovit
N. SalineDEPIN |
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| General Measures |
Patient to sit up, ice pack on nose as first aid, sedation if patient is very anxious, and resting with head at 45 to 90 degrees.
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| Advice to Patient |
Avoidance of nose picking with uncut finger nails.
Sitting up leaning forward during an episode, to prevent blood swallowing |
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| Follow Up |
Incase of recurrence of bleed.
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| Inadequate Response |
Refer to ENT surgeon for packing and other specialized manoeuvre.
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| Prevention |
Application of petroleum jelly to nostril to prevent drying
Avoidance of the nose picking with uncut fingernails..
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