Treatment

Put the patient in a sit up position with the head leaning forward then control bleeding by pinching the nose for 10 -15 minutes, instruct the patients to breathe per mouth in the whole process.

Cauterize septal varices (if any) using a silverex stick  if failed do Anterior nasal packing with adrenaline pack. Remove the nasal packs after 72 hours.

If it  fails in the first two  2hours,Do a posterior nasal packing using a Foley’s catheter introduced through the nasal cavity into the oropharynx, balloon it with normal saline up to 10-15mil while pulling it outward to impinge on the posterior nasal choana.