1. control of bleeding depends on site & cause
1.1. Anterior
1.1.1. Mechanical
1.1.1.1. pressure, external and internal
1.1.2. Pharmaceutical
1.1.2.1. AgNO3, vasoconstrictors, thrombin, Vitamin K w/ FFP, Prothrombin Factor concentrate, TXA, platlets, coke
1.1.3. Electrical
1.1.3.1. cautery (uni & bi polar
1.2. Posterior
1.2.1. Mechanical
1.2.1.1. internal pressure, A&P packing
1.2.2. Pharmaceutical
1.2.2.1. same
2. Procedure;what to do
2.1. get a good Hx
2.1.1. especially meds
2.1.2. prior bleeds
2.1.3. surgeries
2.1.4. diseases
2.2. Clear nose!
2.2.1. blow it clear
2.3. Squirt Lidocaine/cocaine into both sides
2.4. Look for bleeding & treat what you see
2.4.1. silver nitrate very easy
2.4.2. cautery effective
2.4.3. objects(Rhino Rocket, etc. left in situ are problematic
2.4.3.1. obstructed passage, infection, unsightly
3. Why r they bleeding?
3.1. Anticoagulant
3.2. Environment
3.3. Trauma
3.3.1. NG tube in anticoag. pt.
3.3.2. Facial trauma
3.3.3. combined digital disimpaction
3.4. Post -op
3.4.1. CALL THE SURGEON
4. where's the bleed
4.1. Anterior
4.1.1. Kiesselback plexus
4.1.1.1. common w/anticoags, dry air, trauma
4.2. Posterioro
4.2.1. Woodruff's plexus
4.3. Conchae
4.3.1. mucosal tears, fx
4.4. post op & u don't know
4.4.1. CALL