30901 Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method

Name of the Procedure:

Control Nasal Hemorrhage, Anterior, Simple
Common name(s): Nasal cautery, Nasal packing
Technical terms: Anterior epistaxis management

Summary

This procedure involves the application of limited cautery (heat treatment) or packing material inside the nostrils to stop a nosebleed. It's a common treatment for anterior nosebleeds, where the bleeding originates from the front part of the nasal septum.

Purpose

Medical Condition or Problem:

The procedure addresses anterior nosebleeds (epistaxis) that do not stop on their own or with simple first-aid measures.

Goals or Expected Outcomes:

• To stop the loss of blood
• To prevent the recurrence of nosebleeds
• Minimal discomfort post-procedure

Indications

• Persistent anterior nosebleeds
• Bleeding that does not respond to direct pressure, ice application, or nasal decongestants
• Patients with visible bleeding sources in the anterior part of the nasal cavity

Preparation

• No specific fasting or medication adjustments are usually required.
• The doctor may ask about the patient's medical history, including any blood thinning medications or clotting disorders.
• Basic diagnostic assessments might include visual inspection or nasal endoscopy.

Procedure Description

1. Initial Examination: The nasal cavity is examined to locate the bleeding source.
2. Anesthesia: Local anesthesia may be applied to numb the area.
3. Cautery: A small cautery device is used to apply heat directly to the bleeding site to seal the blood vessels.
4. Packing: If cautery is insufficient, gauze or a nasal tampon may be inserted to apply pressure and stop the bleeding.
5. Monitoring: The patient's condition is monitored until the bleeding is controlled.

Tools:

• Nasal speculum
• Cautery device
• Gauze or nasal packs
• Local anesthetic (lidocaine)

Duration

Typically, the procedure takes about 20-30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or an emergency room.

Personnel

• ENT specialist (Otolaryngologist) or trained general practitioner
• Registered nurse or medical assistant

Risks and Complications

Common

• Mild discomfort or pain
• Swelling or minor irritation in the nostrils

Rare

• Infection at the site of cautery or packing
• Recurrent bleeding
• Perforation of the nasal septum (very rare)

Benefits

• Immediate control of bleeding
• Reduced risk of recurrent nosebleeds
• Minimal recovery time

Recovery

• Patients are usually advised to avoid heavy exertion, hot drinks, and nasal picking for a few days.
• Keep the nasal cavity moist with saline sprays.
• Follow-up appointments may be scheduled to monitor recovery.
• Pain management with over-the-counter analgesics if required.

Alternatives

• Simple first-aid measures (pinching nose, ice application)
• Nasal decongestant sprays
• Silver nitrate cautery (another method of cauterization)
• In more severe cases, posterior packing or surgical intervention may be necessary.

Patient Experience

• The patient may feel some pressure and discomfort during the procedure, but it is generally well-tolerated.
• Pain is usually minimal and managed with local anesthesia.
• Post-procedure, minor discomfort and congestion are common but typically resolve quickly.