ENT Emergencies Tips & Tricks | 合法醫療器材資訊網

2013年11月19日—Episode38:ENTEmergenciesPearls,Pitfalls,TipsandTricks·EpistaxisManagement·Whoneedsantibioticsforepistaxis?·Doeselevatedblood ...

Step 1: Visualize the bleed

Ensure proper orientation up-down orientation of nasal speculum (see image). If bleeding, ask pt to blow nose gently to clear clots.

Step 2: Anesthetize 

Apply cotton pledget with 1:1 mix of oxymetazoline (Dristan or Afrin) & lidocaine, which may be more effective than cocaine (& less side effects), using bayonet forceps. Leave in place for 5–10 minutes with the nose *firmly* clamped.

Step 3: Cauterize 

Remember eye and face protection, as silver nitrate causes sneezing. Cauterize dry edges of bleeding site (ie around the site, not on it), for 10–15 seconds maximum. Never cauterize both sides of the septum! Moisturize the area with petrolatum after cautery is complete.

St...