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Epistaxis management on COVID-19-positive patients: Our early case experience and treatment

Samba Siva R Bathula1, Tyler Patrick1, Luxman Srikantha1

  • 1Department of Otolaryngology - Head and Neck Surgery Detroit Medical Center Detroit MI USA.

Clinical Case Reports
|August 25, 2020
PubMed

Insights

Managing nosebleeds in COVID-19 patients requires caution due to high viral load. Initial treatment involves oxymetazoline drops and pressure, with absorbable packing as a secondary option to minimize healthcare worker exposure.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Epistaxis (nosebleeds) in patients with COVID-19 presents unique management challenges.
  • The high virulence and concentration of SARS-CoV-2 in respiratory droplets and nasal secretions raise concerns for healthcare providers.

Observation:

  • Standard epistaxis management protocols may increase the risk of viral transmission.
  • Otolaryngologists must balance effective hemostasis with infection control measures.

Findings:

  • Initial epistaxis management should prioritize non-invasive methods like oxymetazoline nasal drops and direct external pressure.
  • Nasal packing, particularly with absorbable materials, should be considered only after less invasive measures are insufficient.

Implications:

  • This approach aims to reduce aerosol generation and direct contact with infectious nasal secretions.
  • Implementing these strategies can enhance the safety of healthcare workers managing epistaxis in COVID-19 patients.

Keywords:
COVID‐19Merocelepistaxissurgicel

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