For epistaxis, the classic teaching is to pinch the nose to control the bleeding. A persistent nosebleed often is the result of one's natural inclination to constantly check if there is still bleeding every few seconds. Applying pressure on-and-off makes it difficult for the bleeding to stop.
Trick of the Trade:
Use tongue blades to pinch the nose.
Don't rely on the patient to apply constant pressure to the nose. It is too tempting to intermittently check for bleeding. Instead create a "nose pincher" by taping the end of two tongue blades together (at the level of the green arrow). Wedge the nose between the open ends. Leave the tongue blades in place for at least 20 minutes.
The photo is courtesy of my friend Dr. Matthew Lewin.
Must disagree - this is an amateur Lexistat and will fall apart within seconds. For true hemostasis, you need FOUR tongue depressors (not two) and TWO long strips of 1" nylon tape (not one). It is very effective if made properly, and not so if done poorly. One of my co-worker years ago named it in my honor, the Lexistat. Since I cannot patent it and it involves maybe 5 cents worth of material, I request that you give its proper name.
ReplyDeleteGood call, Joe. This is the case of "more is better". A more reinforced nasal-pincher, aka the Lexistat, would definitely do the trick!
ReplyDeleteHi Michelle
ReplyDeleteJust noticed this post after I'd made my video on Epistaxis first aid over at www.edexam.com.au
I got taught this method by an old Emergency nurse many years ago, and made my video to share the technique.
Looks like Joe has already patented it, although a colleague watched my video and said I should call it the "Buck Plug"...
Yes, Joe is always full of amazing tricks. I'm happy to refer to it as the Buck Plug as well!
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