In the Hospital Nasal Packs

The most uncomfortable experience for the patient is that of having a nasal pack removed; accordingly, if packs can be avoided, it is best to do so. If there is a moderate amount of bleeding at the end of surgery, then a pack soaked in 1: 10000 epinephrine can be a

Fig. 13.1 a Fibrinous exudate that sometimes remains at 7 days and requires removal in order to avoid adhesions forming.

b The same patient one month later after suction toilet and douching.

Fig. 13.1 a Fibrinous exudate that sometimes remains at 7 days and requires removal in order to avoid adhesions forming.

b The same patient one month later after suction toilet and douching.

Fig. 13.2a, b Several sterilized nasal sprays are commercially available and many methods exist to help douche the nose.

placed and then removed in the recovery room just before the laryngeal mask is taken out. If there is a little oozing, it will usually stop when the patient is placed 30° head-up after extubation. The bleeding often increases temporarily when the patient wakes up and coughs, as this raises the venous pressure. Any more marked bleeding is best dealt with before the end of surgery; it is usually due to one of the branches of the sphenopalatine artery and is best stopped using suction diathermy.

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