HTHSCI 2F03 Lecture Notes - Lecture 12: Pyogenic Granuloma, Foley Catheter, Nosebleed
26 Dec 2020
School
Department
Course
Professor
Document Summary
Overgrowth of tissue on little"s area due to irritation or hormonal factors. Coagulopathy: warfarin, nsaids, haemophilia, plats, vwd, etoh. If bleeding not controlled remove clots c suction or by blowing and try to visualise bleed by rhinoscopy. Bleeds can be cauterised c silver nitrate sticks. Persistent bleeds should be packed with mericel pack. Refer to ent if this fails or if you can"t visualise the bleeding point. They may insert a posterior pack or take pt. to theatre for endoscopic control. Pass 18/18g foley catheter through the nose into nasopharynx, inflate c 10ml water and pull forward until it lodges. Admit pt. and leave pack for ~48hrs. Gold standard is endoscopic visualisation and direct control: e. g. by cautery or ligation. Swabbing superficial bacteria is irrelevant and can overdiagnosis. Analgesia: ibuprofen / paracetamol difflam gargle. Consider abx only if ill: use centor criteria. Pen v 250mg po qds (125mg tds in children) or erythromycin for 5/7.
