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Epistaxis & Acute Bleeding - Coggle Diagram
Epistaxis & Acute Bleeding
Define Epistaxis: Blood exuding from the nasal cavity.
Examples of acute bleeding: Following extraction, during a dental procedure, or an accident that occurred in the dental office.
Causes:
Digital manipulation
Allergies
cocaine
anemia
.
Symptoms:
Anterior Epistaxis: Oozing blood, Bright red blood
Posterior Epistaxis: Profuse bleeding, dark red blood, gagging, coughing, vomiting
Symptoms:
Excessive bleeding unaffected compression or lasting longer than 2 hours
Fatigue
Hypotension
Reduced mental capacity
Hematoma (collection of blood under the skin, bad bruise)
Treatment: Intraoral:
Apply direct pressure to treatment area by gauze pack or suitable compress technique.
Evaluate after 2-3 minutes of pressure and consider if primary closure of wound can be achieved
Does motion/movement or function reopen wound
If bleeding continues, consider suturing.
Consider the use of hemostatic agents.
Treatment: Extraoral
Apply direct pressure and re-evaluate clotting
Consider the use of a torniquet, however direct pressure is preferred over torniquet.
Consider need for suturing
If patient is stable and injury is minor, patient may be transported by a family member or friend
If wound is unstable or beyond your clinical expertise, apply pressure bandage and transport, via EMS, to ER for suturing and further management.
Prevention of Epistaxis:
Avoid digital manipulation
Moisturize the nasal cavity
Blow nose gently
Use humidifier
Treatment
Try to determine if anterior or posterior bleed.
CAB's
Maintain airway
Apply direct pressure for 15 to 20 minutes.
Have patient breathe through their mouth.
Have basin available or use suction.
Apply an ice pack over the bridge of the nose.
Refer to ER if it does NOT stop
