Lesson 1Anterior nasal packing: types (merocel, ribbon gauze with topical agents), insertion technique, analgesiaWe review kinds of front nose packing like Merocel and ribbon gauze with local medicines, when to use and not, how to put in step by step, pain relief and calm down ways, and watching after putting in.
Choosing Merocel versus ribbon gauze packsTopical vasoconstrictors and hemostatic agentsStepwise insertion technique for anterior packsAnalgesia, sedation and patient counselingPost‑placement monitoring and removal timingLesson 2Relevant laboratory and bedside tests: CBC, coagulation panel, type & screen, blood gas indicationsWe sum up key lab and side-bed tests for bad nosebleed, like full blood count, clotting check, blood type and screen, kidney work, and when to do blood gas, stressing how results guide bringing back life and turning off thinners.
CBC interpretation in acute blood lossCoagulation panel and mixing study basicsType and screen, crossmatch and timingRenal and liver tests affecting hemostasisWhen blood gas analysis is indicatedLesson 3When to escalate: failure of packing, transfusion thresholds, angioembolization indications and referral criteriaWe outline when nosebleed that no stop need more than usual, like seeing packing fail, blood give levels, when for vessel block treatment, and when to send to ENT or higher care and ICU.
Defining failure of anterior and posterior packingTransfusion thresholds in unstable epistaxisIndications for urgent ENT or ICU consultationWhen to request interventional radiology embolizationCriteria for transfer to higher level of careLesson 4Immediate resuscitation: airway protection, breathing, circulation, IV access, monitoringWe describe right away life saving for bad nosebleed using airway-breathing-circulation way, including airway guard, oxygen, vein line, fluid and blood give, watching, and early call for help.
Airway assessment and protection strategiesPositioning and oxygen delivery methodsEstablishing IV access and fluid resuscitationMassive transfusion and blood product useContinuous monitoring and team communicationLesson 5Posterior packing and balloon devices: indications, insertion technique, potential complicationsWe talk when for back nose packing and balloon tools, step by step put in, check if right place, pain relief and watch, and spot and handle problems like low oxygen, dead tissue, and heart rhythm issues.
Recognizing posterior epistaxis candidatesTypes of posterior packs and balloon systemsInsertion technique and placement confirmationAnalgesia, sedation and airway precautionsMonitoring and managing complicationsLesson 6Anterior nasal cautery: indications, technique (silver nitrate), contraindications and safetyWe cover when for front nose burning in nosebleed, pick right patient, silver nitrate way, tools needed, no-go for blood thinner or high risk folks, and safety to stop nose wall hurt or airway block.
Identifying suitable anterior bleeding sitesRequired equipment and preparation stepsStepwise silver nitrate cautery techniqueContraindications and high‑risk situationsComplications, prevention and aftercareLesson 7Anticoagulation management: reversal agents for warfarin, DOACs, heparin; timing and collaboration with hematologyWe review handling blood thinners in bad nosebleed, including turn off ways for warfarin, DOACs and heparin, time for turn off vs stop bleed, risk-gain talk, and work with blood and heart teams.
Risk stratification for holding anticoagulantsWarfarin reversal: vitamin K and PCC useDOAC reversal agents and timingHeparin and LMWH reversal strategiesConsulting hematology and cardiology teamsLesson 8Admission criteria, monitoring plan, discharge instructions, and outpatient follow-upWe set stay in hospital rules for bad nosebleed, like body flow shaky and high risk body issues, watching plans, ward orders, go home words, and set out-patient check to cut repeat and problems.
Indications for hospital or ICU admissionVital sign and airway monitoring protocolsInpatient orders and nursing instructionsSafe discharge criteria and home care adviceTiming and content of outpatient follow‑upLesson 9Focused history and physical exam for epistaxis: bleeding source, anticoagulants, comorbiditiesWe detail aimed story and body check for bad nosebleed, stressing start of bleed, one side or not, blood thinner use, body issues, past times, aimed nose check to find spot, and spot warnings for other sickness.
Key questions about onset, pattern and triggersDocumenting anticoagulants and antiplatelet agentsAssessing comorbidities and bleeding historyFocused nasal and oropharyngeal examinationRed flags for tumors, trauma or systemic diseaseLesson 10Local measures to control bleeding: pressure, topical vasoconstrictors, topical anesthetic techniquesWe explain first local ways to stop nosebleed, like right nose press way, patient place, local shrink blood vessels, and local numb methods that make comfort and see better with small body effect.
Correct external nasal pressure techniqueOptimal patient positioning and suction useSelection and dosing of topical vasoconstrictorsTopical anesthetic choices and applicationAvoiding systemic toxicity from topical agents
