Epistaxis TXA Pack

Jess Mason reviews how to use tranexamic acid (TXA) in an anterior nasal pack for epistaxis that is not resolving wtih compression and vasoconstrictors. We use 1,000 mg of TXA (10 ml), soak gauze, and insert it into the nasal cavity. After 20 minutes the epistaxis has resolved and the packing is removed.

Tim V. -

another option I’ve tried that works is to apply TXA via atomizer. Usually 2.5-5cc then have patient pinch nose.

Fayhan A., M.D. -

I’ve used txa as flush for Merocel, I’ve Inserted Merocel first then flush it with TXA and let it sit there :)

Alonso M. -

This works like magic!
Been using it for 2 years now. Can't remember who suggested it.

GoodCPR -

I prefer not to use the gauze b/c it does have a bit of a rough texture to it. I use a cotton rolled into a cigaret shape and it is a lot more comfortable.

Cory L. -

What is a "cotton" specifically?

Neal A. -

Has anyone tried soaking GelFoam with the TXA and placing it as a temporary anterior nasal pack (for perhaps 2-3 hours), then letting the patient remove the packing at and home?

James H. -

Out of curiosity was this patient on anti-coagulation or have ESRD , etc?

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