Apply Floseal directly to the site of bleeding,allowing it to conform to the shape of the wound
Apply Floseal at a faster rate than the bleeding to prevent product from being washed away due to brisk bleeding
Keep Floseal at the site of bleeding using a damp swab and gentle approximation
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
Once haemostasis is achieved, gently irrigate away excess granules not incorporated into the clot
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:
Upright posture
Ice bag
Compress nostrils etc
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:
Rigid scope, gloves, gown and protective eye wear
Good Light source
Zöllner & Yankauer suckers
Floseal Haemostatic Matrix and applicators
Gauze Pad
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