Foley Catheter to Stop Nosebleed???

A foley catheter, as shown above, is normally used to drain urine from the bladder, but it can also be used to stop severe nosebleeds... albeit under dire circumstances and when there is no other suitable alternative.

Normally, for a severe nosebleed, the nose can be packed with a tampon like packing material. The packing material I like best is a rapid rhino which is illustrated below.

Nasal packing like the rapid rhino exerts pressure within the nose to the point whereby the bleeding stops (like putting direct pressure on a leg wound to stop bleeding).

However, if there's no nasal packing around and the person is having a severe life-threatening nosebleed which almost always is due to a posterior bleeding site, and all you have is a foley catheter...

Use the foley catheter!

Insert the foley through the nose on the side that is bleeding just like an naso-gastric tube...

Once inserted so the catheter can be seen in the back of the mouth, inflate balloon with saline. After inflating the foley balloon, pull the foley catheter back out as if to take the foley catheter out. However, given the foley balloon is inflated, it will snug up in the back of the nose such that it can't be taken out.

Pull on the foley catheter with enough pressure to equal the amount of pressure desired to stop the nosebleed. Once at the correct tension, clamp the foley at the nasal entrance to prevent it from falling back into the nose. Packing with gauze in the front of the nose can also be performed to prevent bleeding coming out the front.

Of course, this is a TEMPORARY measure and should be replaced as soon as possible with appropriate nasal packing material.

But, it certainly works when in a bind.

How Does Nasal Packing Stop Nosebleeds?

It is not unusual for an ENT or an Emergency Room physician to see a patient with a very bad nosebleed... the kind that can potentially be life-threatening given how much active bleeding is occurring.

In these situations, nasal packing is the fastest and best way of stopping the nosebleed.

For any type of active bleeding, direct pressure tamponades the bleeding thereby stopping it... whether it be a stab wound to the leg or a bad nosebleed. In essence, direct pressure exerts a certain amount of pressure that exceeds the blood pressure preventing blood flow. The corollary being if the amount of direct pressure being exerted is LESS than the blood pressure, bleeding will still occur.

With nasal packing, pressure is exerted by the packing material and pressed against whatever the bleeding source is within the nose.

My personal favorite packing material is called the rapid rhino made by Arthrocare (I have no financial ties to the company). It is in essence a balloon covered by a bio-compatible self-lubricating fabric. This device is inserted into the nose in a deflated state. 

Once fully inserted into the nose, it is than inflated using a standard syringe. Enough air is inflated into the device such that the pressure exerted by the balloon exceeds the blood pressure of the vessels within the nose.

The key point here is that enough pressure must be exerted by the balloon device. If the patient's blood pressure exceeds the balloon pressure, bleeding will still occur and MORE air must be pushed in. As such, in patients with high blood pressure, more air must be inflated into the balloon device to stop a nosebleed compared to a patient with low blood pressure.

So, here is what it looks like to insert a rapid rhino nasal packing.

Step 1: After hydrating the fabric, the nasal packing is placed at entrance of nose.

Step 2: Nasal packing is fully inserted into the nasal cavity.

Step 3: The nasal packing balloon is than inflated with enough air pressure to stop the nosebleed.

Obviously, blood pressure must also be controlled and the nasal packing can be removed in about 3 days for patients not taking any blood thinners or anti-coagulants (coumadin, plavix, ticlid, pradaxa, aspirin, ibuprofen, etc). For those on such medications, packing may need to be kept in place longer.

For more information about nosebleeds.

New Webpage on Peritonsillar Abscess Added to Website

Our office has created a new webpage on the evaluation and treatment of peritonsillar abscess.

Peritonsillar abscess is when a pus collection develops behind the tonsil causing a severe sore throat and trouble swallowing.

Read more on how this condition is treated here.