Epistaxis

1. Orders:

    1. IV line fix

    2. Check CBC, PT,PTT, INR, Blood group, Rh

    3. IV infusion 1 lit N/S

    4. Reserve 2 bags P.C (isogroup, isoRh, cross matched, 4u<7 y/o and 2u <9 y/o)

    5. Bilateral nasal x-ray for Fx

    6. Spray Lidocaine 2% 2puff + Spray oxymetazoline 0.05% 2puff

2. Discharge with:

    1. oint tetracycline 3% tds for 10 days #1

        1. or Vit A-D tds

        2. or Vaseline tds

    2. Spray oxymetazoline 0.05% PRN

        1. Nasal drop phenylephrine 0.5% in patient without HTN

        2. or Nasal drop naphazoline 0.05% in patient with HTN

3. use Tampon with Oint tetracycline and Drop phenylephrine for 48 hours

4. use nasal spray sesalin q4h in adults and <12 y/o bid for dry mucosa in nose