Floseal



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Application Technique

  1. Apply Floseal directly to the site of bleeding,allowing it to conform to the shape of the wound.
  2. Apply Floseal at a faster rate than the bleeding to prevent product from being washed away due to brisk bleeding
  3. Keep Floseal at the site of bleeding using a damp swab and gentle approximation.
  4. Wait 2 minutes before inspection (brisk bleeding / coagulopathic patients may require longer). In cases of persistent bleeding, reapply Floseal through existing material to ensure newly applied Floseal reaches the bleeding site itself
  5. Once haemostasis is achieved, gently irrigate away excess granules not incorporated into the clot
  6. Floseal is reabsorbed by the body within 6-8 weeks, consistent with normal wound healing

Floseal in Epistaxis

  • Patient arrives in ED with Epistaxis, clinical assessment of ABC
  • Take conservative first line measure for at least 10 minutes for example
  1. Upright posture
  2. Ice bag
  3. Compress nostrils etc
  4. Take an accurate patient history & send bloods for analysis
  • In case bleeding continues make every attempt to identify the bleeding point.
  • Examination & treatment equipment should include the following:
    • Good Light source
    • Zöllner & Yankauer suckers
    • Floseal Haemostatic Matrix
    • Floseal Malleable & Trimmeable Applicators
    • Gauze Pad
    • (Rigid scope, gloves, gown and protective eye wear)
  • Ensure any blood clots are removed either by the patient gently blowing their nose or suction and apply Floseal to the identified bleeding site inserting the malleable applicator approximately half way (7cm) and fill the nasal cavity
  • Apply bolster gauze under the nose and wait 2 minutes before inspection (brisk bleeding / coagulopathic patients may require longer).
    In cases of persistent bleeding, reapply Floseal through existing material
  • Once haemostasis is achieved, remove excess granules not incorporated into the clot with gentle irrigation or suction. The patient can be discharged following adequate advice once haemostasis has been achieved
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Content by Dr Íomhar O' Sullivan 05/07/2012. Last review Dr ÍOS 4/12/18.