Anterior Nasal Packing for Epistaxis

General · ENT/Emergency · 10–20 min

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

1. Ask patient to blow

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.

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