Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.



Published on

  • Be the first to comment


  1. 1. By dr yasser mandour Epistaxis
  2. 2. Background Epistaxis is another name for what is commonly known as nose-bleeds It is an acute hemorrhage from the nostril, nasal cavity, or nasopharynx Common ED complaint, but 90% of patients can be treated with Occurs up to 60% of general population, but rarely leads to massive bleeding and death
  3. 3. Where does it happen? • Two sources •Anterior (more common) •Posterior (typically common among old patients)
  4. 4. Causes Many different causes – locally, systemically, and environmentally Environmental causes include allergens and humidity Can also be idiopathtic
  5. 5. Common local causes Chronic sinusitis Epistaxis digitorum (nose picking) Foreign bodies Intranasal neoplasm or polyps Irritants Medications Rhinitis Trauma
  6. 6. Common systemic factors Hemophilia Hypertension Leukemia Liver disease (e.g., cirrhosis) Medications Platelet dysfunction/Thrombocytopenia
  7. 7. Treatment Flow of blood normally stops when the blood clots To encourage blood clotting - Pinch the upper fleshy part of nose - Do so for 5-20 minutes - Tilt head forward can decrease the chance of nausea and airway obstruction from swallowing blood - Vasoconstrictive agents can also be used - Other products available to promote coagulation
  8. 8. Packing when simple treatment fails for anterior bleeding •Anterior nasal cavity is packed from posterior to anterior with ribbon gauze that has petroleum jelly •Bayonet forceps and a nasal speculum can be used to approximate accordion folding of gauze •Each layer should be pressed down firmly before next layer is added Bayonet forceps Nasal speculum
  9. 9. Packing for posterior epitasis • Done by Otolaryngologist •A catheter is passed through the nostril and through the nasopharynx and out the mouth •A gauze pack is at the end of the catheter •The gauze pack is guide through the mouth and into the posterior nasal cavity
  10. 10. Other treatments Balloon packing Cauterization of blood vessel Laser therapy Embolization
  11. 11. Prevention Cooler house Vaporizer to return humidity and moisture to the air Nasal saline spray and water soluable jelly (especially for winter months) Avoid picking the nose or blowing the nose too vigorously. Do not strain to bend down or lift anything too heavy.