Epistaxis (nosebleed)

Equipment and Supplies for Dr. Lansford

 

Patient care to coordinate with primary service:

  • Hold blood “thinners,” if able, including anticoagulants, NSAIDs, etc. Use SCDs if needed for DVT prophylaxis.

  • Treat hypertension, trying to maintain SBP < 130 mm Hg

  • Avoid dry air. Consider humidification of supplemental O2, or CPaP. Use a face mask instead of nasal cannulas.

Initial treatment:

  • Elevate head of bed

  • Afrin (oxymetazoline), 2 sprays in each nostril now. Repeat after 5 minutes if needed.

  • Pinch nostrils closed for 5 minutes. The patient can do this manually or use a clothespin-like device, but the nostrils should be pinched closed for 5 minutes straight without letting up to see if there is still bleeding.

  • Calm the patient, as this should help control hypertension driven by emotion.

Drugs to obtain from pharmacy:

  • Afrin (oxymetazoline)

Supplies and equipment from the O.R.:

  • Rapid Rhino nasal packs (variety of sizes, such as 5 cm and 7 cm)

At BroMenn, the OR charge nurse can obtain these during normal business hours. (309) 556-8757

At BroMenn, the After Hours Clinical Coordinator can obtain these on nights and weekends. (309) 268-5389

Supplies to place at bedside:

  • Sterile water (100 mL or more)

  • 10 mL syringe

  • tape