Nose Aid Emergency

Thursday, September 29, 2011

You should have this tool in your first aid box it prevent bleeding of the nose in five minutes and also prevent hand cramps, it is a good tool called " Nose Aid Emergency" instead of your fingers.



How to stop a nose bleed [VIDEO]

These is some you tube videos about nose bleeding and how to stop these bleeding in five minutes, it is work in 90% of cases but remember to visit your specialist in cases of severe bleeding and not causal bleed.



Powerpoint lecture for nose bleeding

these power point of professor algarem about Epistaxis [bleeding from the nose].

treatment of nose bleed [Epistaxis]

Treatment


1.Control the shock:


a.supine position with leg elevation : (sedation-warmth-IV fluids-blood transfer)
b.monitoring the patient: (vital sign-blood gases-hematocrite)


2.1st aid measures:


a.patient is sitting and leaning forward and keep head elevation but not hyper extented.
b.dirct pressure in nostrils for 5-10 min [ it work for 90%]
c.local vasoconstrictors and humidity air.


3. cauterization
a.electrocautery: under general or local anesthesia.
b.chemical cautery: silver nitrate or chromic acid.


4.anterior nasal pack 
a.merocel sponge, vaseline guase
b.removal after 1-2 day.


5.post nasal pack
a.inflatable ballons or rolled guaze
b.1-2 days.


6.surgical treatment: 
a.endoscopic diathermy for sphenopaltine and anterior ethmiodal arteries.
b.embolization with selective angiography may be helpful.
c.ligation:
1.internal maxillary and external carotid arteries :if bleeding occur post from below the middle turbinate.
2.anterior and posterior ethmoidal artery: if bleeding occur superior above middle turbinate.


7.general treatment:
a.rest in bed and sedation.
b.vit k in prothrombin deficiency.
c.vit c  aid capillary wall integrity


8.causal treatment : after treatment the cause


image source







assessment of nose bleeding [Epistaxis]

I'll write these post in the the form of hint in very simple manner , if you want to know more u can read text book.

1.History:

medical history (general illeness).
site: more -anterior.
side:
duration and recurrences.

2.Nasal examination:

Anterior: little area more than 90%.
posterior: below middle turbinate ......spheropalatine artery.
superior: above middle turbinate.........ethmoidal artery.
epistaxis varies in severity from mild to moderate to sevsre and may be fatal

3.General examination:

a.vital data:
blood pressure.....low...shock      high......hypertension.
pulse....rapid...shock.
temperature...high...fever.

b.Systemic examination: to detect general causes of epistaxis [nose bleeding]

c.Hess test : positive in purpura

General causes of epistaxis [Nose Bleeding]

In the last post we talk about local causes of epistaxis (Nose Bleeding) and make it in mnemonics  this post we will study general causes in mnemonics .

pie chart of epistaxis - nose bleeding- causes
General Causes of Nose Bleeding :

1.Venous hypertension [nasal venous congestion]
Mnemonics: CTM in arabic it is كتم (cover)

C.....excessive coughing eg. pertussis, cystic fibrosis, emphysema.
T..... Tumors of the neck and mediastinum.
M.....mitral stenosis and congenital heart failure.

2.Arterial hypertension :
Mnemonics : The first three letters of arterial is ART

A..atherosclerosis
R..renal diseases
T..thyrotoxicosis

3.Blood diseases:
Mnemonics: A PO LHP ....In Arabic it give us meaning of abo lhb evil person

A...anaemia, agranulocytosis  
PO..polycythemia.

LHB.....leukemia, hemophilia, purpura

4.Fever [toxic capillaries]
Mnemonics: ABCD

A....reumatic fever
B....typhoid fever
C....diphtheria
D....exanthemata

5.Deficiency diseases:
1.liver disease [ cirrhosis, failure ]
2.scurvey [ vitC deficiency ]

6.Toxins:

  • Endogenous: 
Mnemonics: Only in arabic it is Ja di re  جدرى

Ja....Jaundice
Di....DKA
Re....Renal failure

  • Exogenous
1.anticoagulants [ heparin and walfarin ]
2.NSAIDS [ anti platelet effect (aspirin) ]
3.VasoDilators [ anti hypertension and estrogen containing drugs ]






Epistaxis

Epistaxis

Definition : Nose bleeding either ant (nasal) or posterior (postnasal).

Causes :
 It is two types local causes and general causes:

 We will make it easy with my mnemonics.....i make it in my ENT Round >>some times my nose bleeds so remember these mnemonics very well.

Mnemonics:  [CTIINS] It is just letters in English but in Arabic it is 60.

Local causes

  1. Congenital: as hemorrhagic telangiectasia (Osler-Weber Render Syndrome).
  2. Trauma: Nose Picking , foreign body, Dirct trauma , surgical trauma.
  3. Inflammatory: Rhinitis(acute or chronic) , Sinusitis (acute or chronic) .
  4. Idiopathic:70%-most common cause-ant-arise from little area.
  5. Neoplastic:Malignancy [nasal-nasopharynx-sinus]   Benign [angiomas-angiofibromas-haemangiomas]
  6. Septal deviation: Spur and Perforation.

 
 
 
 
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