TABLE 2332 Vasoconstrictive and Anesthetic Agents Used in Epistaxis

If the source of bleeding is easily visualized anteriorly, cautery can be attempted with either silver nitrate or electrocautery. Cautery should not be performed indiscriminately. It can lead to septal perforation if used in an overzealous fashion. Silver nitrate sticks can be used as an aid in the management of well-visualized anterior nose bleeds. It should only be attempted after the bleeding has already been stopped and the offending area is well visualized. It is extremely difficult to cauterize an actively bleeding site by chemical means.

Electrical and thermal cautery are best left for the otolaryngologist. It is difficult to control or estimate the depth of cautery achieved with the battery-powered cautery devices available. Significant trauma can occur to the nasal mucosa, septal cartilage, and the skin surrounding the nares.

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