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Epistaxis
• Prof Mulder• 2012
IT IS NEVER A ”DISEASE”
IT IS ALWAYS A SYMPTOM OF PATHOLOGY !!
LOCAL SYSTEMICCongenital etc…….
CONGENITAL INFECTIVE INFLAMMATIONNEOPLASM TRAUMA ALLERGY AUTO - IMMUNEVASCULAR ENDOCRINOLOGYMETABOLICMECHANICALMEDICATION
Rx
TREAT THE CAUSE
WALL CONTENTS
Cells: (Rbc. Wbc. Platelets
Immunoglobulins
Electrolytes Clotting factors
Glucose
Cholesterol etc..
HYPERTENSION
HEADACHEDISPRIN, GRANDPA
EPISTAXIS
Pressure
Ice pack
Plug with cottonwool
( + vasoconstrictor)
Cauterize
LITTLE‘S AREARx
PACKING
Gauze tape
Merocel
+ Foleys catheter
POSTERIOR EPISTAXISRx
Calm the patient
Explain what you are going to do
IV fluidsBlood transfusion
Blow the nose (+ suction)Determine which side is bleeding
Pack the nose: Anterior pack (BIPP, Merocel, Gauze tape) Posterior pack (Foleys catheter)
DANGERS OF NASAL PACKS
No sedation!!!!!!!!
Hypoxia
Antibiotic cover essential
Patient to be admitted
Trauma to nasal vestibule
WHY (HOW) DO THESE CONDITIONS CAUSE EPISTAXIS?
ArteriosclerosisHypertensionCardiac failureDiabetesUraemiaLiver cell failureDrugsLeucemia
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