Epistaxis

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Rocket clouds
Epistaxis by Mind Map: Epistaxis

1. Why r they bleeding?

1.1. Anticoagulant

1.2. Environment

1.3. Trauma

1.3.1. NG tube in anticoag. pt.

1.3.2. Facial trauma

1.3.3. combined digital disimpaction

1.4. Post -op

1.4.1. CALL THE SURGEON

2. where's the bleed

2.1. Anterior

2.1.1. Kiesselback plexus

2.1.1.1. common w/anticoags, dry air, trauma

2.2. Posterioro

2.2.1. Woodruff's plexus

2.3. Conchae

2.3.1. mucosal tears, fx

2.4. post op & u don't know

2.4.1. CALL

3. control of bleeding depends on site & cause

3.1. Anterior

3.1.1. Mechanical

3.1.1.1. pressure, external and internal

3.1.2. Pharmaceutical

3.1.2.1. AgNO3, vasoconstrictors, thrombin, Vitamin K w/ FFP, Prothrombin Factor concentrate, TXA, platlets, coke

3.1.3. Electrical

3.1.3.1. cautery (uni & bi polar

3.2. Posterior

3.2.1. Mechanical

3.2.1.1. internal pressure, A&P packing

3.2.2. Pharmaceutical

3.2.2.1. same

4. Procedure;what to do

4.1. get a good Hx

4.1.1. especially meds

4.1.2. prior bleeds

4.1.3. surgeries

4.1.4. diseases

4.2. Clear nose!

4.2.1. blow it clear

4.3. Squirt Lidocaine/cocaine into both sides

4.4. Look for bleeding & treat what you see

4.4.1. silver nitrate very easy

4.4.2. cautery effective

4.4.3. objects(Rhino Rocket, etc. left in situ are problematic

4.4.3.1. obstructed passage, infection, unsightly