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Related Concept Videos

Epistaxis01:30

Epistaxis

213
Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
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Suctioning the Nasopharyngeal Airway01:29

Suctioning the Nasopharyngeal Airway

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Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
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Drugs Used in Upper Respiratory Disorders: Overview01:16

Drugs Used in Upper Respiratory Disorders: Overview

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Upper respiratory tract disorders, including viral infections and allergic rhinitis, cause significant discomfort and disrupt daily life. Managing these conditions involves a variety of drugs, such as antihistamines, intranasal steroids, decongestants, antitussives, expectorants, and mucolytics. Specific examples of drugs in each category are provided.
Antihistamines (e.g., Benadryl) block histamines from binding. Histamines are chemicals released during an allergic reaction in the body. As a...
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Administering Oxygen by Nasal Cannula01:29

Administering Oxygen by Nasal Cannula

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Oxygen therapy is critical to patient care, especially for those struggling with respiratory issues. This intervention increases the oxygen concentration in the lungs, enhancing the amount of oxygen transported to the body's tissues. One standard method of delivering supplemental oxygen is through a nasal cannula, a non-invasive device that provides low to medium oxygen concentrations.
Nasal Cannulas
A nasal cannula is a lightweight tube split into two prongs placed in the nostrils,...
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Upper Respiratory Drugs: Decongestants01:27

Upper Respiratory Drugs: Decongestants

276
Decongestants are a class of medications used primarily to alleviate nasal congestion, a common symptom resulting from allergies, colds, sinusitis, and other upper respiratory tract infections. These drugs work by activating α-adrenergic receptors, constricting small blood vessels in the nasal membranes. This action results in the opening of clogged nasal passages, thereby facilitating sinus drainage and relieving congestion.
Most decongestants are readily available over-the-counter in...
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Tonsillitis II: Management01:26

Tonsillitis II: Management

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This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
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Related Experiment Video

Updated: Jul 30, 2025

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
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Rhinologist Use of Antibiotics With Nasal Packing for Epistaxis.

Jonathan Ross Mallen1,2, Davis M Aasen2, Jackson Ross Vuncannon1

  • 1Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA.

American Journal of Rhinology & Allergy
|May 17, 2023
PubMed
Summary

Antibiotic prescribing for epistaxis nasal packing is common, especially with non-dissolvable materials. Practices vary significantly by geographic region and physician experience, with toxic shock syndrome cited as a primary concern.

Keywords:
antibiotic prophylaxisepistaxisgeographic practice variancenasal packingtoxic shock syndrome

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Area of Science:

  • Otolaryngology
  • Infectious Disease
  • Medical Practice Patterns

Background:

  • Limited evidence supports prophylactic antibiotic use with nasal packing for epistaxis.
  • Current antibiotic prescribing patterns among otolaryngologists remain unclear.

Purpose of the Study:

  • To characterize antibiotic prescribing practices for epistaxis patients managed with nasal packing.
  • To identify the rationale behind these prescribing decisions.
  • To explore the influence of physician experience, geographic location, and academic affiliation on treatment choices.

Main Methods:

  • An anonymous online survey was distributed to members of the American Rhinologic Society.
  • The survey focused on antibiotic prescribing patterns for epistaxis requiring nasal packing.
  • Descriptive statistics and Fisher's exact tests were used for data analysis.

Main Results:

  • Antibiotic prescription rates were 20% for dissolvable packing versus over 84% for non-dissolvable packing.
  • Physicians frequently cited toxic shock syndrome (TSS) risk (85.6%) as a reason for prescribing antibiotics.
  • Significant regional variations in antibiotic choice (e.g., amoxicillin-clavulanate) and practice patterns were observed, influenced by years in practice.

Conclusions:

  • Antibiotic use is prevalent in epistaxis management involving non-dissolvable nasal packing.
  • Geographic location, physician experience, and practice type significantly influence antibiotic prescribing habits.
  • The study highlights variability in clinical practice for epistaxis treatment.