1. Name of the location of 90% of epistaxis
2. A genetic disorder that forms AV malformations in the skin, lungs, brain etc
3. Name of posterior vascular plexus in the nasal cavity causing posterior epistaxis
4. 1st line treatment for all epistaxis
5. The common brand name for anterior nasal packing
6. Chemical used in cautery sticks
7. Physically scaring complication of posterior nasal packing with foleys catheter
Coming soon..
Virtual Patients - Rhinology - Epistaxis
You attempt nasal cautery, however, the bleeding is too brisk and subsequently you decide to insert an anterior nasal pack (rapid rhino) into the left nostril, parallel to the nasal floor. You inflate this with 10ml of air and this achieves good haemostasis. Knowing this is a painful procedure you prescribe good regular and PRN analgesia.
Unfortunately 50 minutes later the nurse calls you concerned the patient is now bleeding again, this time from the mouth and left the eye. You confirm this to be true upon your review.
The following information is now also available.
Bloods
Hb 95 Na+ 140
WCC 10.5 K+ 3.8
Plt 110 Urea 9.0
MCV 90 Creat 80
INR 2.8
Observations
Pulse 100bpm
BP 165/90
Sats 100% on Air
RR 16
Question
Using all the information you now have available, which of the following would be the best next management step?
