Effectiveness of local hemostasis in nosebleeds in emergency medical care

The problem of achieving high-quality hemostasis in patients with spontaneous nosebleeds (NC) in emergency medical care (SMP) is still relevant. The purpose: to conduct a comparative assessment of the effectiveness of emergency medical care for patients over 18 years of age with anterior NC in the conditions of the NSR using a developed silicone single-chamber intra-nasal tampon with internal point glues, an intranasal (industrial production) balloon and a generally accepted method of tamponade using gauze turunda. Objectives: to analyze the prevalence and causes of NC in the structure of NSR calls in patients over 18 years of age in Moscow; to evaluate the effectiveness of the use of a developed medical device in patients with NC — a single-chamber intra-nasal tampon with internal point glues in comparison with the use of an intranasal balloon and gauze turunda. Materials and methods: An analysis of the structure of calls to patients with NC and an assessment of the effectiveness of stopping NC using an intra-nasal tampon with internal point glues, an intranasal balloon and a gauze turunda were carried out. The results of the study : It was revealed that in all the studied groups, NC occurred in the range from 28% to 37.3% in patients with hypertension who took anticoagulants/antiplatelet agents and in the range from 30.7% to 32% in patients with hypertension without taking anticoagulants/antiplatelet agents. It was found that in the first group of observations using a singlechamber intra-nasal tampon with internal point glues, the best characteristics of the efficiency of stopping NC were revealed: hemostasis was achieved in 92% of cases; less time spent on performing nasal tamponade was 1.6±0.5 min. and the time of onset of hemostasis was 1.2 min±0.3; pain was less pronounced in patients during nasal tamponade — 0.31±0.01 points; fewer repeated calls with recurrent NC (6.7% of cases) and repeated nasal tamponades (2.7% of cases); the call execution time was reduced by 9.5 min. — from 39.3±1.3 min. to 29.8±1.1 min. Conclusion: The data obtained as a result of the study indicate an improvement in the quality of medical care for patients with NC and allow us to recommend a promising expansion of the range of medical devices used to create high-quality hemostasis in NC at the prehospital stage.