Podcast 536:  Epistaxis 101

Podcast 536: Epistaxis 101

Contributor: Dylan Luyten, MD

Educational Pearls:

  • Clear the nasal passages - have the patient, if stable, blow their nose to dislodge any clot that might be in the way
  • Searching for the source of bleeding can be tough. Majority of anterior bleeding is from Kesselbach's plexus
  • Placing a clamp to provide direct pressure is a mainstay of treatment
  • Application of a topical agent, which may include lidocaine epinephrine tetracaine (LET), tranexamic acid (TXA), or oxymetazoline
  • Nasal packing with a nasal balloon or merocel may be necessary if bleeding persists
  • Posterior epistaxis can be potentially devastating - for all practical purposes are epistaxis that does not resolve with anterior packing
  • Interventional radiology can be a helpful consultant for controlling of posterior epistaxis, and may be just as or more helpful than ENT

References

Supriya M, Shakeel M, Veitch D, Ah-See K. Epistaxis: prospective evaluation of bleeding site and its impact on patient outcome. J Laryngol Otol. 2010;124(7):744-749.

Shargorodsky J, Bleier B, Holbrook E, et al. Outcomes analysis in epistaxis management: development of a therapeutic algorithm. Otolaryngol Head Neck Surg. 2013;149(3):390-398.

Singer A, Blanda M, Cronin K, et al. Comparison of nasal tampons for the treatment of epistaxis in the emergency department: a randomized controlled trial. Ann Emerg Med. 2005;45(2):134-139.

Womack JP, Kropa J Jimenez Stabile M. Epistaxis: Outpatient Management. Am Fam Physician. 2018 Aug 15;98(4):240-245.

Liu WH, Chen YH, Hsieh CT, Lin EY, Chung TT, Ju DT. Transarterial embolization in the management of life-threatening hemorrhage after maxillofacial trauma: a case report and review of literature. Am J Emerg Med. 2008 May;26(4):516.e3-5. doi: 10.1016/j.ajem.2007.07.036.

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1146)

Podcast 650: PNES

Podcast 650: PNES

Contributor: Katie Sprinkel, MD Educational Pearls: Psychogenic Non-Epileptic Seizures (PNES) are due to a psychogenic rather than an epileptic cause Despite common assumption, PNES are not always v...

22 Maalis 20216min

Trauma Is A Journey #4 Coming Full Circle

Trauma Is A Journey #4 Coming Full Circle

High in the mountains of Colorado, a crew of unsuspecting docs stumble upon the EMS scene of a head-on collision after an arduous mountain bike ride. Trauma is a Journey is a four part rural trauma mi...

20 Maalis 202119min

Trauma Is A Journey #3 What's In Your Jump Kit

Trauma Is A Journey #3 What's In Your Jump Kit

High in the mountains of Colorado, a crew of unsuspecting docs stumble upon the EMS scene of a head-on collision after an arduous mountain bike ride. Trauma is a Journey is a four part rural trauma mi...

19 Maalis 202123min

Trauma is a Journey #2 The Complete Antidote to Burnout

Trauma is a Journey #2 The Complete Antidote to Burnout

High in the mountains of Colorado, a crew of unsuspecting docs stumble upon the EMS scene of a head-on collision after an arduous mountain bike ride. Trauma is a Journey is a four part rural trauma mi...

18 Maalis 202135min

Trauma is a Journey #1 Setting the Scene

Trauma is a Journey #1 Setting the Scene

High in the mountains of Colorado, a crew of unsuspecting docs stumble upon the EMS scene of a head-on collision after an arduous mountain bike ride. Trauma is a Journey is a four part rural trauma mi...

17 Maalis 202130min

Podcast 649: Normal Triage EKGs

Podcast 649: Normal Triage EKGs

Contributor: Samuel Killian, MD Educational Pearls: Anecdotally, when the computer reads a triage EKG as normal it is most often normal One study tested this theory by examining 855 computer-read EK...

16 Maalis 20213min

Podcast 648: Ivermectin for COVID-19

Podcast 648: Ivermectin for COVID-19

Contributor: Aaron Lessen, MD Educational Pearls: Ivermectin is an antiparasitic medication that has been used for a long time, but has sparked new interest in the past year as a potential treatment...

15 Maalis 20213min

UnfilterED #12: Dr. Don Stader

UnfilterED #12: Dr. Don Stader

If you listen to this podcast, then you're probably familiar with our founder and frequent contributor, Dr. Donald Stader, and his fascination with the intersection of Emergency Medicine, opioids and ...

10 Maalis 20211h

Suosittua kategoriassa Tiede

rss-poliisin-mieli
tiedekulma-podcast
rss-mita-tulisi-tietaa
docemilia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-duodecim-lehti
utelias-mieli
radio-antro
rss-astetta-parempi-elama-podcast
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi