epistaksis english
TRANSCRIPT
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Dr Sari Wulan, SpTHT-KL
Department of Otorhinolaryngology - Head &
Neck Surgery!dayana !ni"er#ity $aculty of %edicine,
Sanglah eneral Ho#pital Denpa#ar
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'pi#ta(i#) from the reek *ord) epi +on #tao +to
fall in drop → .leeding from the no#e
Se"erity of epi#ta(i#) %ild, anterior .leeding that re#ol"e#
#pontaneou#ly Se"ere, po#terior .leeding *ith hypoten#ion,
anemia and air*ay compromi#e that lead todeath
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'tiology)
Local)o Trauma) digital, fracture
o Na#al #pray
o /nflammatory reaction
o 0natomic deformitie#o $oreign .odie#
o /ntrana#al tumor#
o 1hemical inhalant#o Surgery
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Sy#temic)
o 2a#cular di#order#o 3lood cell anomalie#o 3lood cell malignancie#o 0llergie#o %alnutritiono 0lcoholo Hyperten#ion
o Drug#o /nfection
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0nterior .leeding) .leeding from anterior part of#eptum +Little4# area and anterior ethmoidartery
Little area5 Kie#ell.ach ple(u# mo#t fre6uent
area of .leeding
7o#terior .leeding) .leeding from po#teriorethmoid artery, #phenopalatine artery
3leeding commonly #e"ere
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%anagement)
Stop the .leeding8 identified .leeding point aftercleaning the na#al ca"ity
put lidocain & adrenalin gaue for 9 - :; minute# in
na#al ca"ityo When the .leeding #top, .leeding point
cauteriation .y 0gNO< =;-, tri chlor aceticacid :;> or electrocautery
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o When .leeding #till profu#e →packing na#alca"ity *ith ri..on gaue for = day#
o When .leeding #till occur, packing *ith po#teriorpacking + 3ello6
o When .leeding #till occur, ligation of arteryartery) - anterior ethmoidal artery - po#terior ethmoidal artery - internal ma(illary artery
- #phenopalatine artery - e(ternal carotid artery
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7re"ention of complication 1omplication can occur)
- direct from .leeding) #hock
treatment) intra "enou# fluid drip ortran#fu#ion
- effect of gaue packing) infection) middle
ear infection, #inu#iti#
treatment) oral anti.iotic
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7re"ention for relap#e
'pi#ta(i# only #ymptom, importance to detectcau#e of epi#ta(i#
/f the di#ea#e treata.le, epi#ta(i# can notrelap#e
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