Everything about Epistaxis (nasal bleeding) .pdf

This presentation discusses about one of the common conditions, Epistaxis AKA Nasal bleeding.This includes introduction, pathophysiology, vasculature of nasal cavity that leads to bleeding and responsible arterial plexuses,types , etiology, first aid and management of epistaxis.I hope this will be more than enough for your studies.This may be very helpful for medical undergraduates, nurses, other health sector workers and anyone who have curiousity to learn.And also as this give you simple tips for first aid this is useful for anyone openly.Thank you.Wish you good luck.

1. EPISTAXIS
Dip.in Psychology and Counseling
( Nasal Bleeding )
Sankalpa Gunathilaka
MBBS (Sri Lanka)
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2. Content
1)What is Epistaxis?
2)Etiology
3)Vasculature
4)Types
5)First Aid
6)Management
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3. WhatisEPISTAXIS ?
➢ Epistaxis means the bleeding (Loss of blood) from the tissue that lines the
inside of the nose.
➢ Very common
➢ 60% of people will have at least once in the lifetime.
➢ If mild – easily controlled
➢ If severe – life threatening
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4. Etiology
LOCAL
▪Spontaneous
▪Trauma
▪Post operative / Iatrogenic
▪Tumors
▪Hey fever
▪Allergic Rhinitis and other inflammations
GENERAL
▪CVS causes
- Hypertension
- Raised veinous pressure (Mitral Stenosis)
▪Coagulation or Vascular defects
- Hemophilia
- Leukemia
- Anticoagulant therapy
- Thrombocytopenia
▪Fever (rare)
- Typhoid
- Influenza
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5. Vasculature
The arterial supply of the medial and lateral walls of the
nasal cavity is from five sources:
1.Anterior ethmoidal artery (from ophthalmic artery)
2.Posterior ethmoidal artery (from ophthalmic artery)
3.Sphenopalatine artery (from maxillary artery)
4.Greater palatine artery (from maxillary artery)
5.Septal branch of the superior labial artery (from facial artery)
❑Anterior ethmoidal, Sphenopalatine and Septal branch of superior labial
arteries supply the anterior part of the nasal cavity.
❑Posterior ethmoidal and greater palatine arteries supply the posterior
part of the nasal cavity.
❑These vessels anastomoses to form two important arterial plexuses
inside nose.
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6. ➢AKA Keisselbach’s triangle and Little’s area
➢Supply nasal septum
➢Most common site for Epistaxis
➢Anterior bleeding
Two arterial plexuses in nose
Keisselbach’s plexus Woodruff’s plexus
➢Supply the posterior lateral
wall and inferior meatus
➢Bleeding usually manifest as
coffee color vomitus
➢Bleeding down the throat
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8. Types
Spontaneous
▪Common in children and young
adults.
▪From Little’s area
▪Due to infection or minor trauma
▪Easy to stop but tend to recur
Hypertensive
▪Common in older age group.
▪From back or high up in nose
▪Flows back to throat- Coffee colored
vomitus
▪Difficult to stop and may recur
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9. First Aid
➢Place the victim in sitting position with his/her head lean forward.
➢Pinch the nostrils together holding the pressure for several minutes.
➢Apply a towel wet with cold water or ice over the nose, forehead, back of the neck.
➢Loosen the clothing around neck.
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10. Management
▪If bleeding from anterior site : compression by direct digital pressure on lower nose.
▪Cotton wool soaked with Lidocaine and Adrenaline is applied for 5-10 minutes.
▪Cauterization with silver nitrate.
▪Diathermy under local anesthesia for adults and under general anesthesia for children
Nasal packing
technique
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11. Lidocaine 1% + Adrenaline
soaked cotton wool treatment
If bleeding site is visible : cauterize with
silver nitrate or bipolar diathermy
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12. ❑Surgical treatments :
▪Rare

Methods -
▪Submucosal resection
▪Ligation of vessels
▪Angiography and vessel embolization
If severe bleeding occurs : circulatory collapse may result → Circulatory resuscitation
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13. THANK YOU !
Good luck for your studies
07-06-2024
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