Epistaxis - treatmant

Posterior nasal bleed - If the bleeding is posterior, a post nasal pack is required. Post nasal pack is made of gauze which is two finger breadth long and one finger breadth wide.Three threads are suspended from this pack.A catheter is passed from the nasal cavity into the oropharynx and taken out from the mouth. The two threads are fixed with this end and the catheter is pulled from the anterior nares thus taking the pack in the oral cavity, then oropharynx and lastly in the nasopharynx and posterior choana. In this procedure the pack is directed by the index finger of right hand. Once in the posterior choana, the nasal cavity is packed by anterior nasal packing and two threads are secured keeping a dental roll or a piece of gauze between the thread and columella to prevent columellar scarring.The third thread is taken out of the oropharynx and secured with adhesive tape on the cheek. This thread helps in taking out of the post nasal pack after 48 to 72 hours. The procedure can be repeated on the other side also if needed.