1. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S AEPISTAXIS14 - September - 2012Prepared By Dr Gamal Soliman1

2. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S ADEFINITION It is a hemorrhage from the nose caused by rupture of tiny, distended vessels in the mucus membrane of any area of the nose.14 - September - 2012Prepared By Dr Gamal Soliman2 3. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S AOBJECTIVE 1. To control nose bleeding 2. To assess etiology14 - September - 2012Prepared By Dr Gamal Soliman3 4. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S APOLICY 1. Assessment of patients includes: 1.1 Airway status 1.2 Nasal bleeding 1.3 Site of bleeding 14 - September - 2012Prepared By Dr Gamal Soliman4 5. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S APOLICY 1. Assessment of patients includes: 1.1 Airway status 1.2 Nasal bleeding 1.3 Site of bleeding 14 - September - 2012Prepared By Dr Gamal Soliman5 6. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A2. Vital signs are monitored and recorded. 3. Gloves must be worn throughout the procedure. 4. The nurse assists physician during the procedure.14 - September - 2012Prepared By Dr Gamal Soliman6 7. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A5. Suction is done to remove excess blood and clots from the site of infection. 6. Causes of nose bleeding includes: 6.1 Local Dryness leading to crust formation, trauma. 6.2 Systemic hypertension, arteriosclerosis, renal disease bleeding disorders. 6.3 Posterior bleeds are more difficult to control. 14 - September - 2012Prepared By Dr Gamal Soliman7 8. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A MATERIALS & EQUIPMENT 1. Suction 2. Nasal pack tray 3 sizes posterior packs 2.1 #12 RR catheter 2.2 (2) dental bolster 2.3 Scissors 2.4 Mayo clamp 3. Anterior nasal pack Nasal speculum 3.1 Flashlight or ENT headlight 3.2 Packing forcep 3.3 2 x 2 gauze 14 - September - 2012Prepared By Dr Gamal Soliman8 9. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A4. Goose neck lamp with head mirror 5. Gloves 6. Suction 7. Emesis basin with tissue 8. Bowel of water 14 - September - 2012Prepared By Dr Gamal Soliman9 10. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S APROCEDURE RATIONALE 1. Monitor vital signs and record. 1. As data baseline 2. Wash hands and wear gloves. 2. To reduce transmission or microorganism. 3. Inspect with nasal speculum 3. To determine site of bleeding. 14 - September - 2012Prepared By Dr Gamal Soliman10 11. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A4. Collect blood for laboratory analysis 4. To exclude blood dyscrasia. 5. Explain the procedure to the patient instruct to breath gently. 5. To reduce anxiety and gain cooperation.14 - September - 2012Prepared By Dr Gamal Soliman11 12. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A6. Pressure to the soft portion of the nose 5-10 minutes. If the patient is a child or not able to do it, the nurse will apply pressure on the nasal septum for 5-10 minutes. 6. Breathing through the mouth will prevent swallowing of blood.14 - September - 2012Prepared By Dr Gamal Soliman12 13. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A PROCEDURE RATIONALE 7. Place the patient in an upright position leaning forward. 7. To reduce venous pressure. 8. Assist the physician during the Procedures. 8. To detect blood dyscrasias. 9. Provide IV access and draw blood for laboratory analysis.14 - September - 2012Prepared By Dr Gamal Soliman13 14. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A 9. To identify bleeding site. 10. Insert a cotton pledget soaked with a vaso-constricting agent into each nostril and removed after 5-10 minutes. If bleeding continues, nasal packing maybe applied. 10. To apply pressure over the large area.14 - September - 2012Prepared By Dr Gamal Soliman14 15. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A11. Provide tissue and emesis basin 11. To allow patient expectorate any excess blood. 12. Assure the patient that the bleeding be can controlled. 12. Help reduce anxiety. 13. Teach the patient to aavoid forceful nose blowing, straining, high altitudes, and nasal trauma. 13. To prevent epistaxis.14 - September - 2012Prepared By Dr Gamal Soliman15 16. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A16.16.Document the procedure in the nurse's notes. To determine patients response to treatment. 17. Expedite admission, if required.14 - September - 2012Prepared By Dr Gamal Soliman16 17. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S ADISCUSSION14 - September - 2012Prepared By Dr Gamal Soliman17 18. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman18 19. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman19 20. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman20 21. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman21 22. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman22 23. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman23 24. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman24 25. S ilv e r C r e s c e n t D is p e n s a r y K h o b a r - K S A14 - September - 2012Prepared By Dr Gamal Soliman25