Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
Primary survey and escalation triggers
If airway threatened by ongoing hemorrhage
Immediate suction
Immediate airway positioning
If persistent inability to protect airway, RSI with blood-contaminated airway plan
Dual suction setup
Video laryngoscopy first-line if available
If hemodynamic instability or shock physiology
Massive transfusion protocol activation per trauma criteria
Blood products over crystalloid for suspected hemorrhagic shock
TXA IV within trauma protocol window if major trauma with significant bleeding concern (Class I)
If facial trauma with suspected basilar skull fracture
No nasal instrumentation
Early airway strategy and CT imaging priority
Hemorrhage control sequence
Direct pressure
Continuous firm pressure to soft anterior nose for 10-15 minutes
Lean forward posture
Topical vasoconstrictor and anesthetic
Oxymetazoline or xylometazoline topical
Lidocaine with epinephrine topical if available
Source localization once slowed
Anterior bleeding focus versus posterior suspicion
Foreign body or laceration concern
Anterior measures first when safe
Cautery if single visible anterior point and dry field
Anterior packing if diffuse or not localized
Posterior bleed pathway if suspected
Balloon posterior pack or posterior packing device
Early ENT and anesthesia notification
ICU-level monitoring consideration
Trauma-specific red flags
Expanding facial hematoma
Emergent airway planning
CTA head/neck consideration for vascular injury
Clear rhinorrhea
CSF leak concern
Avoid packing through cribriform concern until imaging
Periorbital ecchymosis or diplopia
Orbital fracture concern
CT maxillofacial priority
Malocclusion or trismus
Mandible fracture concern
CT face or panorex per local pathway
Monitoring and access
Two large-bore IV access if significant bleeding concern
Cardiac monitoring if posterior packing, hypoxia risk, or significant comorbidity
Continuous pulse oximetry for ongoing bleeding or sedation
Frequent reassessment for rebleed after interventions
Hemodynamic targets and resuscitation
Perfusion goals
MAP adequate for mentation and end-organ perfusion
Avoid permissive hypotension only within major trauma protocol and without TBI concern
Transfusion approach
Type and screen for moderate bleeding concern
Type and crossmatch for severe bleeding or posterior bleed
Balanced component therapy if massive hemorrhage suspected
Coagulopathy correction
Anticoagulant reversal pathway activation if life-threatening bleed (Class I)
Platelet threshold consideration if thrombocytopenia with ongoing bleeding
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.