Mark Enterprises

Epistaxis is one of the most common nasal emergencies. Typically, anterior epistaxis is a benign self-limited event or resolves by applying direct pressure. Pediatric and elderly populations are most commonly affected by epistaxis, frequently due to direct trauma from nose picking or foreign body insertion, friable mucosa, or anticoagulant use with or without hypertension. In the young and middle-aged adult population, another common cause of epistaxis is intranasal drug use, be it pharmaceutical, such as intranasal steroids, or recreational, such as cocaine. While conservative exist to control anterior epistaxis, nasal packing is sometimes required. This activity reviews the indications and contraindications of anterior nasal packing, outlines the procedural technique for several commercially available nasal packing modalities, and discusses care in the immediate postprocedural period. The activity also highlights the role of the interprofessional team in the management of patients with refractory epistaxis.

Objectives:

• Use best practices when performing an efficient and effective evaluation of a patient presenting with epistaxis.
• Implement proper techniques when placing an anterior nasal pack in a patient for whom conservative methods have failed to achieve hemostasis.
• Identify the most common complications of anterior nasal packing.
• Coordinate with the interprofessional team to provide effective care and appropriate follow-up of patients with epistaxis treated with nasal packing.