SAQ 590 – ENT – epistaxis on dabigatran

A 69-year-old man with ischaemic heart disease, hypertension and atrial fibrillation presents with epistaxis. He takes dabigatran. There has been no trauma, and examination shows brisk anterior bleeding from Little's area.

Haemostasis is achieved and an IV cannula is inserted.

Observation	Result
Blood pressure	195/105 mmHg
Heart rate	92/min
Respiratory rate	12/min
O2 saturation	100% room air
Temperature	36.6 C

State three (3) possible methods to gain initial haemostasis in the first 10 minutes.

(Marked out of 3.0)

/ 3

List two (2) investigations and give one (1) rationale for each.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Investigation</th> <th>Rationale</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> </tr> <tr> <td>2.</td> <td></td> </tr> </tbody> </table> <p>

/ 4

While awaiting investigations, bleeding recurs and persists despite the measures above. List three (3) preferred options for reversal of anticoagulation.

(Marked out of 3.0)

/ 3

State two (2) common scenarios warranting admission for epistaxis.

(Marked out of 2.0)

/ 2

Total Score: 0 / 12

Percentage: 0%