How Do You Use Nasal Packing for Epistaxis?

Nasal packing is a common medical procedure that is performed to control epistaxis
Nasal packing is a common medical procedure that is performed to control epistaxis

Nasal packing is a common medical procedure that is performed to control epistaxis (bleeding from the nose).

Nasal packing may be “anterior” nasal packing that is done by using a gauze inserted inside the nasal cavity after numbing the nasal area. The doctor will douse the gauze in an antibiotic ointment and a medication that squeezes the blood vessels shut.

In case of extensive bleeding, the doctor may need to supplement the anterior nasal pack with the posterior nasal pack. Posterior packing is done with a sterile gauze covered in an antiseptic ointment, a rubber balloon called a catheter or a nasal sponge/tampon.

Most modern posterior nasal packs contain a balloon that can be inflated with a syringe. This arrangement helps in applying an adjustable direct pressure to the site of the nosebleed.

Sometimes both the nasal cavities may need occlusion. The nasal pack is kept inside the nose for 24-48 hours.

What are the other treatments for epistaxis?

Nasal packing is one of the primary procedures in the initial management of epistaxis. If it fails to stop the bleeding, the doctor resorts to the following treatments:

  • Cauterization: This procedure stops the bleeding by burning off the cauterized blood vessels. The heat is created either by applying silver nitrate (a chemical) or by passing an electric current.
  • Discontinuation of medications: Certain medications can increase the amount of bleeding. These include blood-thinning medications, such as Warfarin and Aspirin. Reducing or stopping such medications can be helpful.
  • Prescription medication: Your doctor may prescribe you medications to control your blood pressure. Another medication such as Lysteda (tranexamic acid), which helps in clotting of the blood to stop bleeding, may be prescribed.
  • Foreign body removal: A foreign body in the nose is most commonly seen in children due to any accidental insertion. If this is the cause of the nosebleed, the doctor will attempt to remove the foreign body.
  • Ligation: The blood vessel that is responsible for bleeding is tied off to stop the bleeding.
  • Surgery: If your nose is bleeding due to a trauma or an injury or due to a deviated nasal septum, your doctor may recommend surgical repair of the nose.


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How can you prevent epistaxis?

Most often, epistaxis is a preventable condition. Here is what you can do to reduce your risk of getting it:

  • Keep your nostrils moist:
    • Use saline nasal spray/nose drops two to three times a day.
    • Make use of a humidifier in your bedroom to add moisture to the air.
    • Apply water-soluble nasal gels in your nostrils with a cotton swab. You can find various gels, such as Bacitracin or Ayr Gel, available over the counter.
  • Do not blow your nose too forcefully.
  • If you feel like sneezing, do so by keeping your mouth open. Always sneeze into a tissue or the bend of your arm.
  • Avoid frequent picking your nose.
  • Visit your doctor if you are not able to control nose allergies (such as atrophic rhinitis) that cause dryness.
  • Quit smoking. Smoking dries out your nose and can make you prone to epistaxis.

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Nguyen QA. Epistaxis Treatment & Management. Medscape.