I’ve never been much of a fan of epistaxis – it’s messy, has the potential for life-threatening exsanguination – and involves fiddling around in tight spaces.
My last ‘big bleed’ was in an elderly patient, over-anticoagulated on warfarin with a posterior bleed. Not reassured by her BP of 110 (usually 150) and HR of 90 (on beta blockers), I treat these with a major degree of respect.
Using a RapidRhino can save a lot of guddling around with packing – as the video below shows (using fellow rural doc Dr Jamie Doube as test subject).
So I was intrigued to read about using tranexamic acid for topical application for epistaxis – with suggestion may be more effective than packing for anterior bleeds. I carry TXA in my prehospital pack, on the basis that a 1g load may be useful before definitive care. You can read more about TXA from the LifeInTheFastLane crew HERE.
Can;t wait to give this a go…
Meanwhile, here’s THAT video :