Nasal bleeding, 90% from Little's area (Kiesselbach plexus) anteriorly.
Management
- • First aid: sit forward, pinch soft cartilage for 15 min continuously, ice
- • Topical vasoconstrictor and cautery with silver nitrate to one side of the septum only
- • Anterior packing if bleeding persists; consider tranexamic acid
- • Posterior bleed: balloon catheter, admit, ENT review
- • Correct coagulopathy; check BP
Complications
- • Aspiration
- • Hypovolaemia
- • Septal perforation from bilateral cautery
- • Toxic shock with prolonged packing
Clinical pearls
- • Never cauterise both sides of the septum at the same visit
- • Consider hereditary haemorrhagic telangiectasia in recurrent cases
Related in WardRound
Educational — verify locally.
