Dr Chris Vaillancourt – Epistaxis
Dr Mobin Ataellahi – Spontaneous Splenic Rupture
Both talks are available for download in the CPD Files|Rounds
Take Home Messages
Epistaxis
- Ice on back of neck does not lower nasal blood temperature
- Ask patient to blow nose and remove clot. Allows bleeding point to be visualised and may stop bleeding
- Insert nasal pledget soaked with local anaesthetic and vasoconstrictor (e.g Lidocaine/Otrivin etc). Leave for at least 15 mins.
- Know how to use the various packing devices. Merocel, RhinoRocket, Ultracel, Epistat, etc
- Topical application of injectable form of tranexamic acid is better than anterior nasal packing in the initial treatment of idiopathic anterior epistaxis (500 mg in 5 mL)
- The Skeptics Guide to topical Tranexamic Acid in Epistaxis
Spontaneous Splenic Rupture
- Spontaneous Splenic Rupture is rare
- Remember to enter unexplained shock into SHOC-ED Study
- Infectious Mononucleosis is a risk for Spontaneous Splenic Rupture
- Patients with possible glandular fever who play sport should be tested for Infectious Mononucleosis (IM)
- Patients with IM should be advised to avoid sport for at least 6 weeks with Splenic ultrasound at 4 weeks.