Epistaxis: Treatment Techniques

Simple tamponade

• Pinch ‘soft’ part of nose between thumb and finger for 5 mins.

• Apply ice packs to bridge of nose.

Simple cautery of Little area (Under LA, e.g. Cophenylcaine forte nasal spray ± 5% cocaine solution.) Use one of three methods: electrocautery, trichloroacetic acid or silver nitrate stick (preferred).

Persistent anterior bleed

• Merocel (surgical sponge) nasal tampon or Kaltostat pack or BIPP with ribbon gauze

‘Trick of the trade’ for recurrent anterior epistaxis:

• Apply Nasalate nose cream tds for 7–10 d or

• Rectinol ointment

Severe posterior epistaxis Use a Foley catheter or an Epistat catheter with or without Kaltostat.