Lesson 1Anterior nasal packing: types (merocel, ribbon gauze with topical agents), insertion technique, analgesiaLooks at front nose packing types like Merocel and ribbon gauze with local medicines, when to use, how to put in step by step, pain relief ways, and watching after placing.
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 indicationsSums up main blood tests and side checks for bad nosebleeds, like full blood count, clotting checks, blood type, kidney work, and when to do blood gas, showing how results guide fixes and stopping 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 criteriaSets out when ongoing nosebleeds need more than usual steps, spotting packing fails, blood give levels, when for vessel blocking treatment, and rules for ENT or higher send and ICU move.
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, monitoringDescribes right-away life support for bad nosebleeds using airway-breathing-circulation, with airway guard, oxygen, line in vein, fluids 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 complicationsCovers when for back nose packing and balloon tools, step-by-step put in, check placement, pain relief and watch, and spotting fixing issues like low oxygen, tissue death, and heart rhythm problems.
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 safetyCovers when for front nose burning in nosebleeds, right patient pick, silver nitrate steps, needed tools, no-go for thinned blood or high risk, and safety to stop wall damage 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 hematologyLooks at handling blood thinners in bad nosebleeds, reversal for warfarin, new thinners, heparin, timing vs bleed stop, risk-benefit talks, 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-upSets admit rules for bad nosebleeds like unstable flow and high-risk ills, watch plans, ward orders, home tips, and set clinic checks to cut repeats and issues.
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, comorbiditiesDetails aimed history and body check for bad nosebleeds, stressing start of bleed, side, thinner use, other ills, past bleeds, aimed nose look to find spot, and warning signs for other ills.
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 techniquesExplains first local steps to stop nosebleeds, right nose press way, patient place, shrink nose drops, and numb nose tricks for comfort and see while cutting body effects.
Correct external nasal pressure techniqueOptimal patient positioning and suction useSelection and dosing of topical vasoconstrictorsTopical anesthetic choices and applicationAvoiding systemic toxicity from topical agents
