Episode 982: Epistaxis Management

Contributor: Meghan Hurley, MD

Educational Pearls:

1. Initial Assessment

Start with a physical examination:

Determine if the bleed is anterior or posterior.

Perform a primary survey: assess airway, breathing, and circulation (ABCs).

Airway compromise = intubation immediately.

If the patient is stable, have them blow out any clots, then re-examine the nares.

2. Topical Medications

Anesthetics: provide local anesthesia and pain relief.

Lidocaine

Tetracaine

Vasoconstrictors: reduce bleeding.

LET (Lidocaine, Epinephrine, Tetracaine) is ideal because it provides...