Lesson 1Front nose packing: kinds (merocel, ribbon gauze with local meds), putting in, pain reliefLooks at front nose packing types like Merocel and ribbon gauze with local meds, when to use, not use, step-by-step insertion, pain and calm methods, and after-care checks.
Choosing Merocel versus ribbon gauze packsTopical vasoconstrictors and hemostatic agentsStepwise insertion technique for anterior packsAnalgesia, sedation and patient counselingPost‑placement monitoring and removal timingLesson 2Key lab and bedside tests: full blood count, clotting check, blood group, gas tests when neededSums up main lab and bedside tests for bad nosebleeds, like full blood count, clotting, blood group, kidney checks, and when to do gas tests, showing how results guide fluids and fixes.
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 call for help: packing fails, blood needs, artery blocking signs and referralsSets out when ongoing nosebleeds need more than basics, spotting packing fails, blood levels, when for artery work, and signs for ENT or high care referral 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 4Quick steadying: airway safety, breathing, blood flow, IV line, watchesDescribes first steadying steps for bad nosebleeds using airway-breathing-circulation, with airway guard, oxygen, IV, fluids and blood, watches, and early team calls.
Airway assessment and protection strategiesPositioning and oxygen delivery methodsEstablishing IV access and fluid resuscitationMassive transfusion and blood product useContinuous monitoring and team communicationLesson 5Back packing and balloon tools: when to use, insertion steps, risksCovers when for back nose packing and balloons, step insertion, check placement, pain relief and watches, and spotting, handling issues like low oxygen, tissue death, heart rhythm problems.
Recognizing posterior epistaxis candidatesTypes of posterior packs and balloon systemsInsertion technique and placement confirmationAnalgesia, sedation and airway precautionsMonitoring and managing complicationsLesson 6Front nose burning: when, method (silver nitrate), risks and safetyDeals with when for front nose burning in nosebleeds, right patient pick, silver nitrate steps, gear needed, no-gos for thinned blood or high risk, and safety to avoid wall damage or airway issues.
Identifying suitable anterior bleeding sitesRequired equipment and preparation stepsStepwise silver nitrate cautery techniqueContraindications and high‑risk situationsComplications, prevention and aftercareLesson 7Blood thinner handling: reversal meds for warfarin, new thinners, heparin; timing and blood team linksReviews handling blood thinners in bad nosebleeds, reversal for warfarin, new thinners, heparin, timing vs bleed stop, risks-benefits talks, and links 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 signs, watch plan, home advice, clinic follow-upSets admission signs for bad nosebleeds like unstable vitals and big health issues, 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 9Quick history and exam for nosebleeds: bleed spot, thinners, other illnessesDetails quick history and exam for bad nosebleeds, stressing start, side, thinner use, illnesses, past bleeds, nose exam to find spot, and warning signs for other causes.
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 bleed stops: press, nose tighteners, numbing methodsExplains first local stops for nosebleeds, right nose press, patient place, nose tighteners, numbing ways for comfort and clear views with low 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
