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Transport of a patient with massive traumatic epistaxis using a cricket helmet and posterior nasal packing

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June 1, 2009
by Philip V. Alexander, MS and Alka Walters, MS


In developing countries, when patients with traumatic epistaxis cannot be adequately treated at their local medical facility and require further treatment at a distant tertiary care center, it is important that bleeding be controlled before their transport. We describe a patient with a traumatic anterior ethmoidal artery bleed who needed to be taken to a tertiary care center 8 hours away for endoscopic ablation, which was not available at our hospital. The inflated balloon of an 18-Fr Foley catheter attached to the face guard of a cricket helmet was used as a posterior nasal pack. The patient arrived safely and was successfully treated. This case report illustrates that, in an emergency, readily available materials can be used to effect adequate tamponade of nasal bleeding so that a patient can be transferred safely. We believe this is the only such report in the literature.

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