Lesson 1Front nose packing: kinds (Merocel, ribbon gauze with local meds), putting in, pain reliefLooks at kinds of front nose packing like Merocel and ribbon gauze with local meds, when to use or not, step-by-step putting in, pain and calm strategies, and after-care watching.
Choosing Merocel versus ribbon gauze packsTopical vasoconstrictors and hemostatic agentsStepwise insertion technique for anterior packsAnalgesia, sedation and patient counselingPost‑placement monitoring and removal timingLesson 2Needed lab and bedside tests: full blood count, clotting check, blood type & screen, blood gas when neededSums up main lab and bedside tests for bad nosebleeds, like full blood count, clotting studies, blood type and screen, kidney work, and when to do blood gas, showing how results guide revival and stop decisions.
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 step up: packing fails, blood needs levels, artery blocking signs and referral rulesSets out when ongoing nosebleeds need more than usual steps, spotting packing fails, blood needs levels, signs for vessel blocking treatment, and rules for ENT or higher referral 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 4Quick revival: airway safety, breathing, blood flow, IV line, watchingDescribes first revival steps for bad nosebleeds using airway-breathing-blood flow, with airway safety, oxygen, IV line, fluids and blood giving, 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 5Back packing and balloon tools: when to use, putting in steps, possible problemsCovers when to use back nose packing and balloon tools, step-by-step putting in, check placement, pain relief and watching, and spotting and handling 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 6Front nose burning: when to use, method (silver nitrate), when not, and safetyDeals with when to burn front nose for nosebleeds, right patient pick, silver nitrate method, needed gear, no-gos for thinned blood or high-risk folks, 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: stop drugs for warfarin, new thinners, heparin; timing and work with blood expertsLooks at handling blood thinners in bad nosebleeds, stop plans for warfarin, new thinners and heparin, timing stop vs bleed control, risk-gain talks, and linking 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 8Stay-in rules, watch plan, go-home tips, and clinic check-upsSets stay-in rules for bad nosebleeds like unstable blood flow and high-risk other ills, watch plans, ward orders, go-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 9Targeted history and exam for nosebleeds: bleed spot, thinners, other illsDetails targeted history and exam for bad nosebleeds, stressing start of bleed, side, thinner use, other ills, past bleeds, aimed nose exam to find spot, and spotting warnings 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 ways to stop bleed: press, nose shrinkers, numb methodsExplains first local ways to stop nosebleeds, right nose press method, patient place, nose shrinkers, and numb ways that ease comfort and sight while cutting body-wide 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
