A boy has developed epistaxis. What is the treatment of choice ?
Ans. is 'a' i.e., Digital pressure Management of epistaxis Treatment protocol for management of epistaxis include : ? 1. Conservative Most common site of bleeding is Little's area and most of the time bleeding can be controlled by conservative management which includes : - Nasal pinching : - Pinching of all soft pas of the nose together between thumb and index finger for about 5 minutes can control bleeding most of the time. Trotter's method : - Patient is made to sit, leaning a little forward over a basin to spit any blood and breathe quietly from the mouth. Cold compresses : - Cause vasoconstriction Vasoconstrictor medication on a cotton pledget. Treatment of the etiology : - For example antihypeensives in hypeensive patient. 2. Cauterisation Patient who continues to bleed after properly applied nasal pressure, or a patient with recurrent episodes of bleeding over a period of hours or days, deserve a more definitive procedure. If a presumptive source of bleeding is identified chemical cautery by silver nitrate or coagulation with electrocautery should be considered. 3. Anterior nasal pack Continued epistaxis from an anterior site despite cautery requires placement of anterior nasal pack. 4. Posterior nasal pack The persistent appearance of blood in the hypopharynx with no identifiable anterior source or after placement of an anterior nasal pack indicates posterior site of epistaxis and necessitates placement of posterior nasal pack. 5. Ligation of vessels If bleeding is still continued, surgical ligation of vessels is indicated.
Digital pressure
Nasal packing
Cauterization of vessels
Surgical ligation