Packing of the anterior nasal cavity to control epistaxis.
Indications
- • Anterior epistaxis failing conservative measures
Contraindications
- ⚠ Suspected basal skull #
- ⚠ Facial trauma without imaging
Equipment
- • Nasal speculum
- • Headlight
- • Merocel or ribbon gauze soaked in tranexamic acid
- • Lubricant
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/6)
Tap to complete
Remove clots.
2. Apply topical
3. Inspect
4. Cauterize if visible
5. Insert pack
6. Observe
Immediate complications
- ⚠ Recurrent bleed
- ⚠ Discomfort
Delayed complications
- • Toxic shock (rare) — antibiotics may be considered
- • Pressure necrosis
Recognition
- • Fever, hypotension
Initial management
- • Remove pack; antibiotics
Prevention
- • Time-limited packing 24–48h
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Drugs used in this procedure
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
