Here is a real scenario that happened to a hospitalist.
Pt with posterior epistaxis is bleeding severely. Coughing. O2 sats start going down. Is tachycardia and tachypnea. Patient has cirrhosis and INR is elevated. You call ENT, and ENT says he is in a surgery right now taking care of a posterior epistaxis patient.
What do you do? Attempt of a Rhino Rocket Nasal Packing didn’t work. Patient still bleeding into the back of their throat.
ABCs.
– Position the patient to lean forward, not backward so that it flows out, not into the back of their throat.
– Foley catheterization.
-Transfer patient to ICU
-FFP or PCC