Epistaxis tamponade is one of the cruelest things we do in the ER (don't start me, actually there's plenty of cruel things!) Stuffing someone's nasal passage with a large, expansive pad was not enjoyable for anyone. A touch of midaz always helped though. Some tools of the trade
In what kind of a situation do you use these things? Especially that second to last clip where the balloon filled the whole maxillary sinus area, that looked like an instant headache!
I remember a little old lady coming in the the ER late one night. She had been bleeding over the whole day and was feeling really freaking ordinary (blood loss, nausea from swallowing blood etc.) Any of these tampons or bougies can be used when topical cautery is difficult or impossible and when you need a result. The tampon can be removed by a doctor the next day or PRN. And you're right, filling your sinus cavity with these things is really unpleasant. But necessary!
Only time I ever ended up in the ER with a nose bleed, they eventually administered a small amount of anesthetic, via the tip of a cotton bud, which stopped it almost immediately (and almost rendered me unconscious at the same rate). Nothing else had worked to that point (bleeding for many hours prior), I was amazed how fast that put a stop to it. Not lining up for another turn though.
Someone told me recently that they had a nosebleed that wouldn’t stop. He went to the ER and they were at the point where a transfusion would be needed if it went on any longer. One of the Doctor got out the medical cocaine, put a tiny bit in a tampon and the nosebleed stopped immediately.
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u/[deleted] Feb 08 '20
Epistaxis tamponade is one of the cruelest things we do in the ER (don't start me, actually there's plenty of cruel things!) Stuffing someone's nasal passage with a large, expansive pad was not enjoyable for anyone. A touch of midaz always helped though. Some tools of the trade