11/13/24, 7\:24 PM Guide | Nasal cautery

Nasal cautery

Table of contents

Indications and risks

Nasal cautery is a procedure performed in cases of anterior epistaxis which do not stop with
episodes of epistaxis.
Cautery involves using silver nitrate sticks to cauterise and seal the bleeding point.
The procedure is a quick, simple and e
including\:
Further bleeding
Septal perforation
Intranasal adhesions

Gather equipment

Gather the appropriate equipment\:
Non-sterile gloves
Apron
Headlight
Thudicum nasal speculum (Figure 1)
Topical anaesthetic agent
Cotton ball
Nasal forceps
Silver nitrate cautery sticks (Figure 2)
https\://app.geekymedics.com/osce-guides/clinical-procedures/nasal-cautery/ 1/311/13/24, 7\:24 PM Guide | Nasal cautery
Nasal speculum

Introduction

Wash your hands and don PPE if appropriate. A headlight is useful as a light source when performing nasal cautery.
Introduce yourself to the patient including your name and role.
Con
Brie
" T o d a y , I w i l l b e p e r f o r m i n g n a s a l c a u t e r y ,
w h i c h i s a p r o c e d u r e t h a t i n v o l v e s s e a l i n g t h e b l o o d v e s s e l s o n t h e i n s i d e o f t h e n o s e t o s t o p n o s e b l e e d i n g. T h e r e m a y b e
s o m e d i s c o m f o r t a n d b l e e d i n g , b u t i t i s ge n e r a l l y s a f e a n d e
"
Gain consent to proceed with nasal cautery.
Check for any contraindications to performing cautery\:
Inability to see the source of bleeding
Hypersensitivity or allergy to silver nitrate
Position the patient so that they are sitting comfortably.

Performing nasal cautery

1. Wash your hands and don gloves and an apron (if not already done).
2. Administer topical anaesthesia to the nasal cavity using a cotton ball and forceps or spray. Wait several minutes for the
anaesthesia to take e
3. Insert the nasal speculum into the a
prominent vessel or bleeding point is identi
4. Use a rolling motion to apply the silver nitrate stick to the prominent blood vessel and surrounding mucosa in a peripheral to
1
central direction for approximately
produce a grey residue.
2
5. Remove the cautery stick and the nasal speculum from the nasal cavity.
https\://app.geekymedics.com/osce-guides/clinical-procedures/nasal-cautery/ 2/311/13/24, 7\:24 PM Guide | Nasal cautery
Cautions
Important cautions to be aware of when performing nasal cautery include\:
3
Limit the contact time between the cautery stick and nasal mucosa - 5-10 seconds is usually su
Never cauterise both sides of the nasal septum simultaneously, as this can result in a septal perforation
If bilateral septal cautery is required, the treatments should be separated by 4-6 weeks to allow time for mucosal
healing

To complete the procedure...

Explain to the patient that the procedure is now complete.
Thank the patient for their time.
Provide appropriate aftercare advice\:
4,5
Prescribe a topical antiseptic cream (e.g. naseptin) to be applied to both nostrils twice a day for two weeks. This will prevent
infection and promote healing following cauterisation. Check the patient is not allergic to nuts, as naseptin contains peanut
oil.
Advise the patient to avoid nose blowing, strenuous activity and heavy lifting for at least one week
Optional\: advise patients to apply vaseline to their upper lip to avoid silver staining
Re-iterate epistaxis
Safety netting\: if there is nosebleeding for >20 minutes despite
department
Epistaxis
Basic
Sit upright and lean the head forward
Pinch the soft, lower cartilaginous portion of the nose for at least 10-15 minutes
Apply an icepack to the bridge of the nose or back of the neck to promote vasoconstriction
Breathe gently through the mouth and avoid swallowing blood
Dispose of PPE appropriately and wash your hands.
Document the details of the procedure, including\:
Safety netting and aftercare advice
Any immediate post-procedure concerns or complications

Reviewer

Mr Alex North
ENT registrar
Source\: geekymedics.com
https\://app.geekymedics.com/osce-guides/clinical-procedures/nasal-cautery/ 3/3