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Epistaxis
• Prof Mulder• 2012
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IT IS NEVER A ”DISEASE”
IT IS ALWAYS A SYMPTOM OF PATHOLOGY !!
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LOCAL SYSTEMICCongenital etc…….
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CONGENITAL INFECTIVE INFLAMMATIONNEOPLASM TRAUMA ALLERGY AUTO - IMMUNEVASCULAR ENDOCRINOLOGYMETABOLICMECHANICALMEDICATION
Rx
TREAT THE CAUSE
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WALL CONTENTS
Cells: (Rbc. Wbc. Platelets
Immunoglobulins
Electrolytes Clotting factors
Glucose
Cholesterol etc..
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HYPERTENSION
HEADACHEDISPRIN, GRANDPA
EPISTAXIS
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Pressure
Ice pack
Plug with cottonwool
( + vasoconstrictor)
Cauterize
LITTLE‘S AREARx
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PACKING
Gauze tape
Merocel
+ Foleys catheter
POSTERIOR EPISTAXISRx
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Calm the patient
Explain what you are going to do
IV fluidsBlood transfusion
Blow the nose (+ suction)Determine which side is bleeding
Pack the nose: Anterior pack (BIPP, Merocel, Gauze tape) Posterior pack (Foleys catheter)
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DANGERS OF NASAL PACKS
No sedation!!!!!!!!
Hypoxia
Antibiotic cover essential
Patient to be admitted
Trauma to nasal vestibule
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WHY (HOW) DO THESE CONDITIONS CAUSE EPISTAXIS?
ArteriosclerosisHypertensionCardiac failureDiabetesUraemiaLiver cell failureDrugsLeucemia
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