First aid: Sit up, lean forward, pinch the soft part of the nose firmly for 10–15 min; ice pack (AAO-HNS 2020)
Still bleeding: Silver nitrate cautery of a visible point, or anterior nasal pack; check BP, Hb and INR if on warfarin; refer if posterior (AAO-HNS 2020)
Investigations
First visit
BP — Every patient.
Only if indicated
CBC, PT/INR — Heavy or recurrent bleeding, anaemia, or on warfarin or other anticoagulants.
Nasal endoscopy — Recurrent bleeding, one-sided obstruction, or teenage boy (angiofibroma).
Blood group and crossmatch — Heavy bleeding.
Locked
The adult dose for each drug
The child dose, where the card gives one
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.