Correct! You should perform a physical exam to evaluate the site of the bleed. An appropriate understanding of the blood supply to the nose is important in managing epistaxis.
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Review of Nasal Vasculature |
Before initiating a physical exam, make sure to gown, glove, and wear eye protection. Prior to visualizing the nasal cavity, appropriate anaesthetic and vasocontrictive agents should be applied. Cotton swabs soaked in Lidocaine, epinephrine, and 4% cocaine and inserted into the nasal cavity will do the trick. This will help you visualize the ruptured vessel while preventing any unnecessary discomfort to your patient. You then perform a nasal speculum exam and see a red spot indicating the site of the bleed.
Fig 3. Endoscopic view of the site of the bleed
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Physical Exam FYI |