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Emergency Medicine Journal 2009;26:52; doi:10.1136/emj.2008.062182
© 2009 BMJ Publishing Group Ltd and the College of Emergency Medicine.

SHORT REPORTS

Technical tutorial: how to pack a nose with bismuth iodoform paraffin paste gauze safely and effectively

F Amen, A Pace-Balzan

ENT Department, St John’s Hospital, Chelmsford, UK

Correspondence to:
Dr F Amen, 18 Poseidon Court, Homer Drive, London E14 3UG, UK; furrat{at}hadbai.co.uk

ABSTRACT

The current primary treatment for epistaxis in accident and emergency departments is the insertion of Merocel packs. If these are properly inserted, but fail to control bleeding, it is necessary to insert a bismuth iodoform paraffin paste (BIPP) pack. A BIPP pack, when properly inserted, has the potential to stop most bleeds, but books and journals suggest a method of insertion that limits its effectiveness. A safer and more effective way of packing a nose with BIPP than the traditional method is described.


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The journal is co-owned by and the official journal of College of Emergency Medicine

Official journal of British Association for Immediate Care: BASICS, Faculty of Pre-Hospital Care, Irish Society for Immediate Care and Swedish Society for Emergency Medicine: SweSEM

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