Epistaxis
Learning Aims & Outcomes
Case 1: Introduction
Hereditary Haemorrhagic telangiectasia (HHT)
Case 1: Symptoms
Case 1: Signs
Case 1: Investigations
Case 1: Management
Nasal First Aid
Other Options
Anterior Packings
Common Bleeding Sites of the Nose
Blood Supply of the Nose
Case 1: Next Step
Case 2: Presentation
Case 2: Mext Steps
Summary
References
Feedback
Epistaxis
Case 2: Mext Steps
Continued..
Mr. Jamieson starts becoming increasingly drowsy…
Your patient is progressing into
shock! (specifically hemorrhagic shock)
Question
What are your next steps?
(Please arrange as appropriate)
A.
-
Obtain IV access (2 wide bore cannulas) and collect bloods for FBC, LFTs, X-match, Coagulation screen
Contact ENT: Urgent surgical arrest of haemorrhage may be required (endoscopic sphenopalatine artery ligation in most cases)
Assess your patient (A-E assessment) and apply nasal first aid as able
Actively replace volume loss with appropriate blood products
Reassess patient and closely monitor vital signs
Call for help: Initiate major haemorrhage protocol
Reverse any clotting abnormalities
B.
-
Obtain IV access (2 wide bore cannulas) and collect bloods for FBC, LFTs, X-match, Coagulation screen
Contact ENT: Urgent surgical arrest of haemorrhage may be required (endoscopic sphenopalatine artery ligation in most cases)
Assess your patient (A-E assessment) and apply nasal first aid as able
Actively replace volume loss with appropriate blood products
Reassess patient and closely monitor vital signs
Call for help: Initiate major haemorrhage protocol
Reverse any clotting abnormalities
C.
-
Obtain IV access (2 wide bore cannulas) and collect bloods for FBC, LFTs, X-match, Coagulation screen
Contact ENT: Urgent surgical arrest of haemorrhage may be required (endoscopic sphenopalatine artery ligation in most cases)
Assess your patient (A-E assessment) and apply nasal first aid as able
Actively replace volume loss with appropriate blood products
Reassess patient and closely monitor vital signs
Call for help: Initiate major haemorrhage protocol
Reverse any clotting abnormalities
D.
-
Obtain IV access (2 wide bore cannulas) and collect bloods for FBC, LFTs, X-match, Coagulation screen
Contact ENT: Urgent surgical arrest of haemorrhage may be required (endoscopic sphenopalatine artery ligation in most cases)
Assess your patient (A-E assessment) and apply nasal first aid as able
Actively replace volume loss with appropriate blood products
Reassess patient and closely monitor vital signs
Call for help: Initiate major haemorrhage protocol
Reverse any clotting abnormalities
E.
-
Obtain IV access (2 wide bore cannulas) and collect bloods for FBC, LFTs, X-match, Coagulation screen
Contact ENT: Urgent surgical arrest of haemorrhage may be required (endoscopic sphenopalatine artery ligation in most cases)
Assess your patient (A-E assessment) and apply nasal first aid as able
Actively replace volume loss with appropriate blood products
Reassess patient and closely monitor vital signs
Call for help: Initiate major haemorrhage protocol
Reverse any clotting abnormalities
F.
-
Obtain IV access (2 wide bore cannulas) and collect bloods for FBC, LFTs, X-match, Coagulation screen
Contact ENT: Urgent surgical arrest of haemorrhage may be required (endoscopic sphenopalatine artery ligation in most cases)
Assess your patient (A-E assessment) and apply nasal first aid as able
Actively replace volume loss with appropriate blood products
Reassess patient and closely monitor vital signs
Call for help: Initiate major haemorrhage protocol
Reverse any clotting abnormalities
G.
-
Obtain IV access (2 wide bore cannulas) and collect bloods for FBC, LFTs, X-match, Coagulation screen
Contact ENT: Urgent surgical arrest of haemorrhage may be required (endoscopic sphenopalatine artery ligation in most cases)
Assess your patient (A-E assessment) and apply nasal first aid as able
Actively replace volume loss with appropriate blood products
Reassess patient and closely monitor vital signs
Call for help: Initiate major haemorrhage protocol
Reverse any clotting abnormalities
Please answer each row
