Bleeding from the nose
POPULARITY
In dieser Folge räumt Cordelia mit hartnäckigen Mythen rund ums Nasenbluten auf und zeigt, wie man in akuten Situationen richtig reagiert. Nasenbluten kann plötzlich auftreten und dramatisch wirken – ist aber meistens harmloser, als es aussieht. Nasenbluten oder Epistaxis, heute erfährst du alles über Ursachen, Soforthilfe und Prävention.
In this episode, Tracey Davidoff, MD and Joe Toscano, MD discuss the November 2024 Evidence-Based Urgent Care article, Management of Epistaxis in the Urgent Care SettingIntroductionNovember 2024 Issue OverviewUnderstanding Epistaxis: Causes and ConcernsEvaluating and Managing EpistaxisSpecial Populations and ConsiderationsControversies and Cutting-Edge TreatmentsDisposition and Follow-UpFinal Points and PearlsConclusion and Upcoming Topics
Interview med Paramediciner Svend Vittinghus vedr. hans semester opgave på Bachelor of science i Paramedic studies. Svend har lavet en opgave med udgangspunkt i et scoping review, et form for litterature review. Svend har forsøgt at belyse den tilgængelige viden om behandlingen af epistaxis med topical TXA præhospitalt.
We remember 9/11 for a second, along with a brand new single by Toronto's The Slime and our house band, Portland's Carny Cumm! More Outlandishness from Inland Empire's Saddam Bin Laden, and a bunch of new ones we've been waiting to play. Thanks for your support! Hit us up at brothersgrimpunk@gmail.com and download our music on our Bandcamp page... including the new Crickets EP.474 Playlist:Punk walk...Toronto Crab Walk 1:43 The Slime 2024 Bandcamp Single Indonesia Raw Noise Ungovernable 0:50 Svälter Arsenal of Mindfuck Portland CRYPT CREEP 0:43 SOCIETY'S SICKOS 4 TRACK DEMO Portland Sent Bone 0:52 Carny Cumm 2024 Bandcamp Single Land of the Nobodies (bkgrd) 3:13 Rocketsled Absolute Zero USA BOMBS 1:29 Saddam Bin Laden 2024 Single Gouden Regel 0:49 Seein'Red Seein'Red-No Way split UK Neurotic Hate Fiends 1:51 War Corpse Life After Work? Newfoundland SNITFIT 1:32 snitfit Snitfit - Demo Painters Tapes MI Low Art 1:27 H8 Mile Spread the Love Falsos Positivos - Kill, fascist, kill! 1:39 Nothing to Harvest Records ΝΤΗ052. Falsos Positivos/false(-)negative - Split UK Fairtrade Death 1:47 PARLIAMENT RUINS Piss Take FRUSTRACIÓN 1:18 FERVOR MORTAL E.C. #032 - DEMO AU Jackhammer 1:32 Exit Mould EP Krak Down (bkgrd) 3:22 Gwar This Toilet Earth HARDHEAD 1:28 CONFUSION'S PRINCE DMU-019: CONFUSION'S PRINCE - S/T AGNOSTIC FRONT 0:37 Who's To Blame DMU-017: WHO'S TO BLAME - DEMO Ghostspace Recs TX Time To Spare 2:23 Temporary Curse BEEP THRASH Knuckles On Stun TN Big Bopper - My Movie 2:08 Various Artists Delinquents & Shitbags Shit Bots - Wild Man 1:35 Various Artists Delinquents & Shitbags Let's Get Ripped 1:22 Meatwagon Arrival Mucky Pup 1:42 The Exploited Punks not dead I Drew This Skinhead for You 1:10 Close Combat 2019 Earth Brains 1:07 Ancient Filth Earth Brains Flexi Don't Need You 0:53 BGP One Small Step For Punk... Talk is Poison (bkgrd) 3:04 POR097 Sonic Warhead - Bleed Runner EP Fear Power Control 1:03 Payload of Atomic Warhead Nightmares Summer 2014 Tape Satan Is Good But You're Asshole 1:40 童子 (Dohji) Forced Climax EP Put Me Down 1:14 Tokyo Lungs ST EP I Hate People 0:33 Distemper Distempter Berlin Hunter Of The Universe 1:05 Overthrow Overthrow EP Tape Pitts Stop the Lies 0:43 Real Enemy Life With The Enemy SLO Under the Knife (EP) 1:39 Half Life All Our Yesterdays Get Bent 0:44 Cross-Contamination Epistaxis - DEMO No Good 1:51 The Afterdarks Rock N' Roll is Dead TN Nobody Told Me It Was Bandcamp Friday 0:52 Vista Blue Vista Blue Are The Pop Punk Preservation Society Cerveza y ruido (bkgrd) 3:37 Brigada Bastarda demo 2023 Popular Affliction L.A. Dirt Nap 1:29 Gylt I Will Commit a Holy Crime Other ways to hear BGP:Archive.org#474 on ArchiveApple PodcastsYouTube PodcastsPunk Rock Demonstration - Wednesdays 7 p.m. PSTRipper Radio - Fridays & Saturdays 7 p.m. PSTContact BGP:brothersgrimpunk@gmail.com@Punkbot138 on Instagram@BrosGrimPunk on XMore Music:Bandcamp - Follow us and download our albums: Brothers Grim Punk, Fight Music, and more!YouTube - tons of our punk playlists, from Anarchy to Zombies!
In the this episode, Dr. Christopher Tookey and Dr. Rose Wobrink review how to stop a nose bleed. They dive in to technique as well as some medicines that can help. They then review how to prevent them (hopefully) We're providing general guidance but everyone is different and you should always discuss with your health care professional management of any disease and therapy before trying anything you discover from a source on the internet (including this podcast). This podcast does not reflect the opinion of our employer.
In this episode, we review the high-yield topic of Epistaxis from the Ear, Nose, & Throat section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
The ABMP Podcast | Speaking With the Massage & Bodywork Profession
A client with frequent nosebleeds works with a massage therapist on TMJ pain, and something unexpected happens: she goes from 3-4 bleeds a week, to about one. The therapist has referred her to get more information about her sinus health, which is a good idea. But is there anything else they can be doing? Sponsors: Books of Discovery: www.booksofdiscovery.com Anatomy Trains: www.anatomytrains.com MassageBook: www.massagebook.com EmbodyU: www.embodyu.net Host Bio: Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com. Resources: Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app Association of Hypertension With the Risk and Severity of Epistaxis | Bleeding and Transfusion | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network (no date). Available at: https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2770570 (Accessed: 28 May 2024). Durham, J. and Wassell, R. (2011) ‘Recent Advancements in Temporomandibular Disorders (TMDs)', Reviews in Pain, 5(1), pp. 18–25. Available at: https://doi.org/10.1177/204946371100500104. Epistaxis and Hypertension: Reviewing a Complex Relationship (no date) Medscape. Available at: https://www.medscape.com/viewarticle/epistaxis-and-hypertension-reviewing-complex-relationship-2023a1000i7t (Accessed: 28 May 2024). ‘Epistaxis: Practice Essentials, Anatomy, Pathophysiology' (2024). Available at: https://emedicine.medscape.com/article/863220-overview?&icd=login_success_email_match_fpf (Accessed: 28 May 2024). Karegeannes, M. (2018) Red Flags, Treating TMJ. Available at: https://www.treatingtmj.com/symptoms/red-flags/ (Accessed: 28 May 2024). Nose Bleeds at Night: 5 Causes (2017) Healthline. Available at: https://www.healthline.com/health/nose-bleeds-at-night (Accessed: 28 May 2024). Nosebleeds (Epistaxis): Causes, Treatment & Prevention (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis (Accessed: 29 May 2024). Nosebleeds: When It's Time to Get Medical Attention (2021) Columbia University Irving Medical Center. Available at: https://www.cuimc.columbia.edu/news/nosebleeds-when-its-time-get-medical-attention (Accessed: 28 May 2024). Image of Kiesselbach Plexus Credit: FirstAdmiral, CC-SA-3.0
Take Home Points: Posterior epistaxis is a rare, life-threatning presentation. The key is in identifying and rapidly gaining control with a posterior pack or foley catheter. These patients often require surgical intervention so get ENT to the bedside and admit to a place with a higher level of monitoring. REBEL Core Cast 123.0 – Posterior ... Read more The post REBEL Core Cast 123.0 – Posterior Epistaxis appeared first on REBEL EM - Emergency Medicine Blog.
Podcast summary of articles from the February 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include sepsis, e-scooter trauma, GI bleeds, firearms, renal stones, and pediatric epistaxis. Guest speaker is Dr. Dustyn Whitesel.
Dr. Mike Olson, former EM PA and now ENT attending sits down to talk about epistaxis with Alex and Venk. We go through a pragmatic approach to epistaxis, discuss some nuance cases including telangiectasia, hypertension, and anticoagulation. interventions are key, what patients are most likely to suffer a bad outcome and more. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Ingason AB, et al. Warfarin is associated with higher rates of epistaxis compared to direct oral anticoagulants: a nationwide propensity score-weighted study. J Intern Med. 2022 Sep;292(3):501-511 Thomg JF, et al. A prospective comparative study to examine the effects of oral diazepam on blood pressure and anxiety levels in patients with acute epistaxis. Journal of Laryng & Otol. 2007. (121)124-129 Terakura M et al. Relationship between blood pressure and persistent epistaxis at the emergency department: a retrospective study. J Am Soc Hypertens. 2012 Jul(4):291-295 Lee CJ, et al. Evaluation of the relationship between blood pressure control and epistaxis resource after achieving effective hemostasis in the emergency department. J Acute Med. 2020 mar 1;10(1)27-39
A look at nosebleeds (Epistaxis), including the most common causes and pathophysiology, possible consequences, and epistaxis management including nasal first aid, second line therapies and surgery. Consider subscribing on YouTube (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 What is Epistaxis? 0:13 Epistaxis Pathophysiology1:01 Epistaxis Causes (Nosebleed Causes) 2:07 Epistaxis Diagnosis2:55 Epistaxis Treatment (Nosebleed Treatment Including Nosebleed First Aid) ReferencesENT SHO (2022) Epistaxis. Available at https://entsho.com/epistaxisAyesha Tabassom; Julia J. Dahlstrom - Stat Pearls (2022) Epistaxis. Available at https://www.ncbi.nlm.nih.gov/books/NBK435997/.)Please remember this podcast and all content from Rhesus Medicine is for educational and entertainment purposes only and is not a guide to diagnose or to treat any form of condition. The content is not to be used to guide clinical practice and is not medical advice. Please consult a healthcare professional for medical advice.
I read from episcopacy to epistaxis. The word of the episode is "episodic". Theme music from Tom Maslowski https://zestysol.com/ Merchandising! https://www.teepublic.com/user/spejampar "The Dictionary - Letter A" on YouTube "The Dictionary - Letter B" on YouTube "The Dictionary - Letter C" on YouTube "The Dictionary - Letter D" on YouTube "The Dictionary - Letter E" on YouTube Featured in a Top 10 Dictionary Podcasts list! https://blog.feedspot.com/dictionary_podcasts/ Backwards Talking on YouTube: https://www.youtube.com/playlist?list=PLmIujMwEDbgZUexyR90jaTEEVmAYcCzuq https://linktr.ee/spejampar dictionarypod@gmail.com https://www.facebook.com/thedictionarypod/ https://www.threads.net/@dictionarypod https://twitter.com/dictionarypod https://www.instagram.com/dictionarypod/ https://www.patreon.com/spejampar https://www.tiktok.com/@spejampar 917-727-5757
Getting to the Bottom of Nosebleeds and How to Manage Them Effectively Join Dr. Reddy and Dr. Undavia as they cover the primary cause behind a common occurrence—nosebleeds. Understanding their root causes and learning how to manage them is essential for maintaining your well-being. In this episode of We Nose Noses, we dive deep into the reasons behind nosebleeds and provide practical tips for effective management. What you'll learn: Why certain situations and conditions make individuals more susceptible to experiencing nosebleeds Where within the nasal passages nose bleeds occur and leading factors that contribute How to stop a nosebleed and the preventive measures to minimize the occurrence of nosebleeds By understanding the leading cause of nose bleeds and mastering effective strategies for prevention and management, you can regain a sense of control over your nasal health. Join us in this episode to equip yourself with the insights you need to tackle nose bleeds head-on. Don't miss this informative discussion – it might just provide the answers you've been seeking. Subscribe to our podcast, leave a review, and stay tuned for more valuable episodes on nasal health. Your well-being matters to us! https://njent.com/what-is-the-most-common-cause-of-epistaxis-nosebleeds/ __ NJ ENT & Facial Plastic Surgery 5 Greentree Center Suite 117 Marlton, NJ 08053 609-710-NOSE (6673) www.njent.com
Bonjour bonjour ! Si toi aussi tu avais toujours cette personne qui se mettait à saigner du pif de manière totalement aléatoire en cours de sport ou pendant un contrôle (comme par hasard !), alors ce petit épisode est fait pour toi et te permettra d'y voir plus clair dans le diagnostic et la prise en charge des épistaxis. Je te souhaite un beau début de semaine, et plein de courage pour la fin de l'année ! On se retrouve mercredi, bises
Epistaxis (nosebleed) is one of the most common ear, nose, and throat (ENT) emergencies that present to the emergency department. Understanding how to manage it is imperative for all emergency clinicians. This week ENT Registrar Veena , outlines her approach to Epistaxis .The episode we discussed the 5 pillars of epistaxis management Pressure, topicalisation, Visualisation, Packing and Surgical Treatment. The episode will leave you with a better understanding of epistaxis management. Show notes -approach-to-the-adult-with-epistaxis - click to follow link - https://litfl.com/a-case-of-epistaxis/- click link to download - 2023 -
This week let's re-enter the nasal cavity & focus our attention on its blood supply. Why does the nose have such a significant blood supply? What vessels contribute to it? And what happens when it breaks? The terms covered this week are Little's area or Kiesselbach's plexus & Woodruff's plexus. The blood vessels with the mnemonic L.E.G.S, Labial (Superior), Ethmoids (anterior & posterior), Greater palatine & Sphenopalatine arteries.
In this episode, host Dr. Amber Luong speaks with Dr. Devyani Lal and Dr. Tripti Brar. They discuss their recently published article: Biological sex as a modulator in rhinologic anatomy, physiology, and pathology: A scoping review. Read the article in the International Forum of Allergy and Rhinology. Listen and subscribe for free on Apple Podcasts , Google Podcasts and Subscribe […]
Langston and David answer a listener's email about lightskinned people getting more nosebleeds. Send your conspiracy theories, music drops, and any problematic talks to mymommapod@gmail.com We are now on YouTube! Listen & Watch episodes of My Momma Told Me. Subscribe to the channel here!See omnystudio.com/listener for privacy information.
Or, in layperson's terms, nose bleeds!
Enterate cuáles son las causas del sangrado nasal
An “old wives' tale” has persisted in the treatment of anterior epistaxis. A practice article in CMAJ entitled, "Five things to know about anterior epistaxis" discusses what many are doing wrong and the proper way to treat anterior epistaxis. On this episode, co-author and rhinologist Dr. Leigh Sowerby elaborates on the causes and the full suite of options for treating this common cause for emergency department visits.Next, Drs. Bigham and Omole speak with Dr. Michelle Sholzberg, a hematologist and medical director of the coagulation laboratory at St. Michael's Hospital about how to determine if a patient may have a bleeding disorder and needs investigation. Dr. Sholzberg discusses the usefulness of the INR and PTT and then goes on to call out structural sexism in hematology, and in the diagnosis of bleeding disorders, in particular. "Five things to know about anterior epistaxis"CMAJ
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Mit **Folge 56** starten wir in ein neues Kapitel, das Kapitel Atmung. Wir beginnen mit der Nase und betrachten diese von allen Winkeln einschließlich Physiologie und Patholgie. Viel Spaß beim Zuhören und Lernen ;-) Den Youtube-Kanal findest du hier: https://www.youtube.com/channel/UCvJEv1PMae-i4ey_274tbwQ Das Preismodell für das Coaching findest du unter www.tanjas-naturheilkunde.com/lerncoaching. Hier findest du auch den Link, um ein kostenloses Erstgespräch online zu buchen. Falls du den Podcast unterstützen möchtest, geht es hier zu den Monats- und Jahrespaketen: https://steadyhq.com/wissensreise Schreib mir gerne Anregung, Kritik, eine Coaching-Anfrage oder einfach nur ein "Hallo", auch an die Adresse: tanjaloiblhp@gmail.com. Auf Instagram findest du mich unter: tanjas_naturheilkunde
Lauren and JJ welcome Licensed Veterinary Technician Elena Graves back to the podcast to discuss a case of epistaxis in a dog. This episode includes an in-depth discussion of nasal aspergillosis. References: 1. Hillsman S, Tolbrert KM: Differential diagnosis: Epistaxis. Clinician's Brief. August 2018. https://www.cliniciansbrief.com/article/differential-diagnosis-epistaxis 2. Robinson NG: Yunnan baiyao: Facts & myths. Clinician's Brief. January 2016. https://www.cliniciansbrief.com/article/yunnan-baiyao-facts-myths 3. Brister J, Morgan RV: Aspergillosis/ penicillosis, nasal (canine). VINcyclopedia of Diseases. June 2019. www.vin.com 4. Sharp NJH, Harvey, CE, Sullivan M: Canine Nasal Aspergillosis and Penicilliosis . Compend Contin Educ Vet 1991 Vol 13 (1) pp. 41-49. 5. Vangrinsven E, Duprez JN, Taminiau B, et al.: Comparison of culture-dependent and -independent methods on nasal swabs in dogs with nasal discharge. European College of Veterinary Internal Medicine - Companion Animal Online Congress 2021. 6. Stepaniuk KS, Gingerich W: Suspect odontogenic infection etiology for canine lymphoplasmacytic rhinitis. Journal of Veterinary Dentistry 2015; 32(1): 22-29. DOI: 10.1177/089875641503200103 7. Biénès T, Vangrinsven E, Fastrès A, et al.: Utility of fungal polymerase chain reaction on nasal swab samples in the diagnosis and monitoring of sinonasal aspergillosis in dogs. Journal of Veterinary Internal Medicine 2022; 36(4): 1295-1302. DOI: 10.1111/jvim.16441 Special Guest: Elena Graves.
This month we're taking a look at Epistaxis. It's a common presentation with a varied degree of severity. You might not thing there's much to learn about managing a nose bleed, but that's where you'd be wrong. There's a number of things we need to consider when assessing these patients and several treatment options to consider. Find the article and our other podcasts at www.generalbroadcast.org.uk
First, there was Episode 31: TXA for Epistaxis (the Zahed RCT from Tehran), then there was Episode 40: TXA for Epistaxis, Part Deux (the NoPAC trial), now there's Episode 64: TXA for Epistaxis, Part Trois, another Iranian RCT. So... we have conflicted evidence, all from RCTs, about whether TXA works for epistaxis. Dr. Jarvis goes through the prior trials and then gives a more detailed look at the new evidence. He closes by talking about how he handles conflicting evidence. Citation: Hosseinialhashemi M, Jahangiri R, Faramarzi A, et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Annals of Emergency Medicine. 2022;80(3):182-188. doi:10.1016/j.annemergmed.2022.04.010See omnystudio.com/listener for privacy information.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode734. In this episode, I'll discuss whether the manner of tranexamic acid application changes the effectiveness for epistaxis. The post 734: Does the manner of tranexamic acid application change the effectiveness for epistaxis? appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode734. In this episode, I ll discuss whether the manner of tranexamic acid application changes the effectiveness for epistaxis. The post 734: Does the manner of tranexamic acid application change the effectiveness for epistaxis? appeared first on Pharmacy Joe.
The GenerEhlist - CCFP Exam & Canadian Primary Care Medicine
Written & Researched By: Thomsen D'hont Peer Review By: Shaila Gunn (MS4 UBC) Episode Art By: Aikansha Chawla Join Thomsen and Caleb as we cover the seven key CCFP topic objectives for Epistaxis. Learn how to teach your patients to correctly squeeze the nose, an approach to epistaxis even if recurrent, when to refer, and workup and differential.
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: https://emrapidbombs.supercast.tech They say you can't pick your friends but you can pick their noses- wait, that's just wrong! Let's pick the pearls (hehe) of presentation, diagnosis, and management of epistaxis.
In this episode, we review the high-yield topic of Epistaxis from the Ear, Nose, Thorat section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
It's the JournalFeed Podcast for the week of August 16-20, 2021. We cover detecting central vertigo on exam, silver nitrate for recurrent epistaxis, cerebral venous thrombosis, spotting RV dysfunction in PE on CT, and D-dimer in pregnancy.
Learn to recognise and manage a nose bleed on the ward or in the Emergency department. Risk factors, anatomical locations and basic approach to management of epistaxis. Please feel free to comment on Twitter or Instagram @virtualwardrounds or via email VirtualWardRounds@gmail.com Photo used under Creative commons licence original can be found here https://www.flickr.com/photos/chloerae/2307147694/
Epistaxis is the medical term for a nosebleed. This is a common occurrence in kids, and is usually due to a combination of nasal mucosa, plus trauma like picking and the effects of drying from the air around us. They usually don't need to be investigated, unless they occur often, are resistant to basic measures or there if there are other red flags - which we will discuss further in this episode! Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingrightpod@gmail.com Make sure you hit SUBSCRIBE/FOLLOW so you don't miss out on any pearls of wisdom and RATE if you can to help other people find us! (This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)
¡Bienvenido Galeno! ⚕ Te invito a que visites mi https://linktr.ee/dra.espinoza para tener acceso a mayor contenido bibliográfico y te sea de mayor utilidad. ¡ÉXITO EN TODO!
¡Bienvenido Galeno! ⚕ Te invito a que visites mi https://linktr.ee/dra.espinoza para tener acceso a mayor contenido bibliográfico y te sea de mayor utilidad. ¡ÉXITO EN TODO!
This episode covers nosebleeds in children.Written notes can be found at https://zerotofinals.com/paediatrics/ent/nosebleeds/ or in the ear, nose and throat section of the Zero to Finals paediatrics book.The audio in the episode was expertly edited by Harry Watchman.
Date: March 4th, 2021 Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. Joseph's Regional Medical Center in Paterson, NJ. Managing editor of EM:RAP and Associate Editor at REBEL EM. Reference: Reuben A et al. The Use of Tranexamic Acid to Reduce the Need for Nasal Packing in Epistaxis (NoPAC): Randomized Controlled Trial. Ann Emerg […]
Welcome to the new revision series of EyeRevise where I'll be joined by fellow junior doctors and we'll be going through core medical topics. In this episode we will be exploring Epistaxis with Dr Ashish Vasudev. While we have made every attempt to ensure that the information contained in this podcast is reliable and accurate to the best of our ability. I am not responsible or liable for any errors or omissions, or for the results obtained from the use of this information. --- Send in a voice message: https://anchor.fm/ahoane-qureshi/message
IR Sabeen Dhand and ENT Ashley Agan discuss management of Epistaxis, including how to effectively pack the nose, and when SPA ligation or arterial embolization are necessary. Dr. Dhand also describes his arterial embolization technique, including important pitfalls to avoid. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xQPc7h --- SHOW NOTES In this episode, Dr. Sabeen Dhand, an Interventional Radiologist, joins our hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss epistaxis and the evaluation and management of different causes of epistaxis. Dr. Agan and Dr. Dhand start the discussion by bringing up common presentations of epistaxis from both an ENT standpoint as well as IR; with the usual presentation being initially to ENT with possible referral to IR for embolization. They then continue to speak about initial treatments for epistaxis in the ED, which entails use of pressure, Afrin, and nasal packing or cauterization. If those measures aren't sufficient, further examination in the OR may be warranted to find specific location and cause. In the case of a posterior nosebleed, usually from the sphenopalatine artery (SPA), with brisk bleeding and/or failure of ligation, SPA embolization by IR may be of use. Dr. Dhand mentions a contraindication for SPA embolization in the case of the ophthalmic artery anastomosis between the Internal Carotid Artery and External Carotid Artery due to risk of stroke and blindness. Different sources of bleeding should also be evaluated. The discussion rounds off with the summarization of initial treatment of epistaxis. Two important considerations include proper nasal packing, pushing back into the nose and not straight up, as well as avoiding compressing nasal structures and causing necrosis and further mucosal irritation increasing bleeding risk.
Tranexamic acid (TXA) is a synthetic lysine derivative that binds with the lysine site on plasminogen, inhibits fibrinolysis and stabilizes clot. While it has been around since the 1960's, its popularity for major trauma has gained a lot of steam in recent years. This has also resulted in creative emergency providers finding novel uses for it at the bedside. In this podcast, Dr. Tim Fallon discusses some of the more novel bedside uses of TXA including epistaxis, hemoptysis, post tonsillectomy bleeding, and dental trauma. Click Here for the Show Notes on Downeastem.org References Zahad, R. A new and rapid method for espistaxis treatmetn using injectable form of tranexamic acid topically: a randomized controlled trial. AJEM. 31 (2013)1389-1392.[Pubmed] Wand, O. Inhaled Tranexamic Acid for Hemoptysis Treatment. Chest. 2018; 154(6):1379-1384.[Pubmed] Schwarz, W. Nebulized tranexamic Acid Use for Pediatric Secondary Post-Tonsillectomy Hemorrhage. Annals of Emerg Med. in Press. [Pdf] Dietrich, S. Trick of the Trade: Topical Tranexamic Acid Paste for Hemostasis. ALiEM. https://www.aliem.com/category/clinical/tricks-of-the-trade/ Mason, J. Epistaxis TXA Pack. EMRAP HD. May 2018 Rezaie, S. TXA for Everyone: Inhaled TXA for Hemoptysis. RebelEM. Rezaie, S. Topical Tranexamic Acid for Epistaxis or Oral Bleeds. RebelEM
A short and sweet episode where I finish reviewing EENT diseases: Rhinorrhea, Epistaxis and Sore Throat. The Strength of TCM Workbook, digital downloads, study charts and practice support are all available at kentonsefcik.com Track is Samurai Code by Levox: levox.bandcamp.com
This week we discuss the ED management of anterior and posterior epistaxis. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_89_0_Final_Cut.m4a Download 3 Comments Tags: ENT, Epistaxis, Nose Bleeds, TXA Show Notes Take Home Points The first step is managing epistaxis is solid pressure. This means holding a tight pinch just distal to the nasal bones and hold, without peaking, for at least 5 minutes. This will stop a good deal of the bleeding. If you need to do more, start by soaking gauze in either oxymetazoline or epinephrine, mix in some lidocaine to help with anesthesia, pack the nare with that and add on some compression. Hope fully this stops the bleeding enough that you can see a good bleeder and perform cautery. Third line of treatment would be to try some soaked gauze, but this time with TXA. Can't hurt to try! And then last resort is of course packing. Here make sure the patient is anesthetized with some lidocaine, lubricate the packing well and apply horizonally, no vertically as we are often tempted.
Don't forget to wear protective gear. Gown up! Initial Encounter History Anticoagulants Easy bleeding/bruising Lightheadedness Exam Pallor Tachycardia/Hypotension Step 1: Put on Personal Protective Equipment Gown Gloves Mask Eye Protection Step 2: Clear Nose and Visualize Bleeding Have patient blow out/remove any clot and look for source of bleed Kiesselbachs plexus “Anterior” epistaxis Sphenopalatine artery […]
This week we discuss some information on influenza testing in the ED and management of epistaxis. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_18_0_Final_Version.m4a Download Leave a Comment Tags: Epistaxis, Influenza Show Notes Show Notes EMCrit: Dominating the Vent I http://emcrit.org/lectures/vent-part-1/ EMCrit: Dominating the Vent II http://emcrit.org/podcasts/vent-part-2/ ALiEM: Neuraminidase Inhibitors for Influenza – The Truth, The Whole Truth, and Nothing But the Truth. Finally. EM Lit of Note: Remember, Tamflu is Still Junk. EM Lit of Note: Which Review of Tamflu Data do You Believe? Zahed R et al. A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. Am J Emerg Med 2013; 31: 1389-92. PMID: 23911102 Derkay CS et al. Posterior nasal packing.
This week we discuss some information on influenza testing in the ED and management of epistaxis. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_18_0_Final_Version.m4a Download Leave a Comment Tags: Epistaxis, Influenza Show Notes Show Notes EMCrit: Dominating the Vent I http://emcrit.org/lectures/vent-part-1/ EMCrit: Dominating the Vent II http://emcrit.org/podcasts/vent-part-2/ ALiEM: Neuraminidase Inhibitors for Influenza – The Truth, The Whole Truth, and Nothing But the Truth. Finally. EM Lit of Note: Remember, Tamflu is Still Junk. EM Lit of Note: Which Review of Tamflu Data do You Believe? Zahed R et al. A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. Am J Emerg Med 2013; 31: 1389-92. PMID: 23911102 Derkay CS et al. Posterior nasal packing. Are Intravenous antibiotics really necessary?