Three areas to discuss when undertaking any kind of procedure The three main areas to analyze before any procedure are; competency of the patient/surrogate to make a vital decision, disclosure of details/information and voluntary nature of decisions.

Three areas to discuss when undertaking any kind of procedure The three main areas to analyze before any procedure are; competency of the patient/surrogate to make a vital decision, disclosure of details/information and voluntary nature of decisions.

The groups of nosebleeds and which is most common?
There are two kinds of nosebleeds namely posterior and anterior, an anterior nose bleeding occurs when one’s the vessels at the front of the nose breaks hence bleeding while posterior occurs at the deepest or back part of one’s nose causing blood to flow down the throat. The common type of nosebleed is anterior nosebleed (Jain & T Deshmukh, 2021).
Indications for involvement by a provider for a nosebleed.
1. If the patient has anemic symptoms like shortness of breath, heart palpitations and pale complexion.
2. If the patient is taking any type of blood-thinning medications like warfarin or have a hemophilia.
3. If the patient is a kid below 2 years and as a nosebleed.
4. Lastly, if the patient has regular nosebleeds.
Horizontal or vertical way of using nasal speculum and why
The nasal speculum ought to be placed vertically. This is done to avoid further bleeding and eradicate traumas. Also, do not assume unilateral nasal discharge in a kid.
Ways of delivering vasoconstrictive solution
Intranasal administration is an alternative for systematic and local delivery of therapeutic agents. This method is noninvasive and painless and is suitable for kids, application can be undertaken by physicians or patients in emergency setups. Intranasal drug delivery results to quick therapeutic impacts. hepatic first- pass metabolism and Nasal application circumvents gastrointestinal degradation of the medication. Nasal drops could also be used.
How long should you apply pressure with the stick?
Two minutes would be enough but the mode of treatment will depend on the case. The period that the tip touches the tissue concludes the extent of the subsequent action. Sliver nitrate sticks are utilized for cauterization and it is important to use pressure during the treatment (Sekito et al., 2022).

Why it is it significant not to use the silver nitrate for over that time frame?
This is because the silver nitrate stick gets activated when it comes into contact with moisture and when used in wounds it delivers silver ions on the body’s tissue hence forming an eschar as they lead to binding of tissues and obstructing of vessels in the body.
After hemostasis is obtained, what are three types of treatment methods that can be used to protect the cauterization site?
The bleeding can be controlled using silver nitrate cauterization. Managing the vessels leading to the site prior to tackling the bleeding site. Evade forceful and random cautery and cauterization.
Electro cauterization using an insulated sunction cautery unit is a technique for serious bleeding. The efficiency of these two techniques can be made effective by utilizing rigid endoscopy more so in the instance of posteriorly in the bleeding areas.
After managing the bleeding, it would be vital to recommend use of antibiotic ointment and saline spray and to evade vigorous activities for about 7-10 days. NSAIDs such as ibuprofen and manipulation of the nose should also be avoided.
If that had not stopped the bleeding and you had to make the decision to use a nasal sponge or nasal tampon, what should the sponge/tampon be coated in and how long should it be left in place?
Should be coated in antibiotics and afterwards left for about 48 hours.
After putting in the nasal sponge/tampon, approximately 2 ml of ________ or _______ should be dripped onto the tip to help the sponge expand.
Water or blood
After placing the nasal sponge/tampon, the patient should be closely monitored for 3-5 minutes. Why is that?
This is done to ensure hemostasis.
How long should the patient be kept in observation status?
About 10-30 minutes.
If a sponge/tampon is used, is it necessary to use antibiotics?
Systematic prophylactic antibiotics are not necessary in most epistaxis patients who have nasal packs (Baugh & Chang, 2018). Using topical antibiotics may be cost friendly, suitable and efficient. Using this mode of treatment algorithm will aid in standardizing use of systematic antibiotic in patients with epistaxis with nasal packing and ought to minimize expenses linked with pointless utilization of such kind of medication (Womack et al., 2018).
If it is necessary to pack the nose, it may be advisable to give the patient a narcotic or sedative medication (unless a contraindication exists). Why?
After surgery, gauze is put high up in a patients nose to allow soaking of fluids like blood and water. The gauze can be changed or left for some days. In the emergency department, nasal packing for anterior epistaxis is for unresolved bleeding after direct pressure, cautery and vasoconstructive medications are used. Other clues for anterior nasal packing are oral maxillofacial surgery, surgical processes by oto