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TREATMENT OF MINOR EPISTAXIS First aid

There are two methods of cautery. The first employs a caustic chemical, silver nitrate, which is commercially available as a bead of chemical fused to the end of a long wooden stick, like an oversized kitchen match. Under surface anaesthetic this can be applied painlessly to the offending blood vessel. Unfortunately the results are not always satisfactory. The alternative technique of cautery uses a hot wire (electrocautery) and requires better local anaesthetic, or general anaesthesia in children. In my experience it is a much better technique, as the blood vessels causing the bleeding can be etched out and coagulated with good control. Some surgeons use the operating microscope for this purpose, which further improves visibility. Electrocautery is successful in the majority of cases.