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.