A big bleed in an adult is a medical emergency with the prime objective to stop the bleeding. This is usually done in the hospital casualty with the insertion of a tamponade balloon (Rapid Rhino). The amount of blood loss is determined, and blood given if necessary.

The Nose Specialist takes over and attempts to find the cause and the site. In a high percentage of cases the bleed is posterior requiring surgery. The large end branch of the internal maxillary artery is identified using telescopes and camera systems. This vessel is then occluded with cautery, and the nose packed with a dissolving plug.

Epistaxis, Causes, Signs and Symptoms, Diagnosis and Treatment