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 647: INR and Liver Failure

Podcast 647: INR and Liver Failure

Contributor: Erik Verzemnieks, MD Educational Pearls: INR measures the clotting cascade including factors II, VII, IX, and X Coumadin most commonly elevates the INR, and it is used to monitor the an...

9 Maalis 20213min

Podcast 646: Thunderclap Headache, Think...RCVS?

Podcast 646: Thunderclap Headache, Think...RCVS?

Contributor: Aaron Lessen, MD Educational Pearls: When evaluating a thunderclap headache, don't forget RCVS! RCVS: reversible cerebral vasoconstriction syndrome Due to reversible spasms of cerebra...

8 Maalis 20213min

Podcast 645: Necrotizing Enterocolitis and More

Podcast 645: Necrotizing Enterocolitis and More

Contributor:  Peter Bakes, MD Educational Pearls: Necrotizing Enterocolitis (NEC) Presents in the first few days of life (often in the NICU) to 3 weeks old Risk factors include prematurity, excess ...

2 Maalis 20219min

Podcast 644: Covid Outcomes

Podcast 644: Covid Outcomes

Contributor: Aaron Lessen, MD Educational Pearls: Meta-analysis of 57,420 COVID+ patients evaluated mortality after intubation 45% mortality rate for all patients in the study 84.4% mortality in p...

1 Maalis 20213min

Podcast 643: Convulsions with Gastroenteritis

Podcast 643: Convulsions with Gastroenteritis

Contributor: Jared Scott, MD Educational Pearls: Differential Diagnosis: non-accidental trauma, febrile seizure, meningitis, hyponatremia, epilepsy Convulsions with gastroenteritis is a known entity...

23 Helmi 20215min

Podcast 642: Vasopressors

Podcast 642: Vasopressors

Contributor: Nick Tsipis, MD Educational Pearls: Epinephrine: alpha-1, alpha-2, beta-1, and beta 2 agonist - used in cardiac arrest with positive effects on ROSC in prehospital and peri-hopsital set...

22 Helmi 20218min

Podcast 641: Leadless Intracardiac Pacemaker

Podcast 641: Leadless Intracardiac Pacemaker

Contributor: Jared Scott, MD Educational Pearls: Small capsule pacemaker (2.5 cm, 1 ml volume) resides in the heart without any associated wires or leads like a traditional pacemaker The new version ...

16 Helmi 20216min

Podcast 640: Kawasaki's Disease

Podcast 640: Kawasaki's Disease

Contributor: Peter Bakes , MD Educational Pearls: Pediatric Fever + Rash Differential: scarlet fever, measles, rubella, chicken pox, fifth's disease, HHV-6, adenovirus, anaphylaxis, Kawasaki's diseas...

15 Helmi 20215min

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