Epistaxis - treatment

Anterior nasal packing - If the bleeding point on the septum is not found then one has to pack the nasal cavity. For this following packing materials can be used -

1. Ribbon gauze impregnated with BIPP (bismuth iodoform pyro phosphate) or any antibiotic ointment.The ointment acts as lubricating and moistening agent as well as an antiseptic.The ribbon gauze can be layered in the nasal cavity in two ways, either layer on layer horizontally or vertically. Most of the time this anterior packing is enough to control the bleeding by tamponading effect. This is taken out mostly after 48 hours.

2. Readymade packs like merocel can be used which are less traumatising on nasal mucosa. After placing the pack in the nasal cavity, it is made wet by putting saline on it. The pack swells and controls bleeding by pressure effect.

3. Catheters are available with an inflatable baloon which is infatted after inserting the catheter in nasal cavity.

4.Nasal packs are also available with an inner airway for the patient to breathe through it.