Hartley and Axon made a number of recommendations for managing epistaxis with a Foley catheter. The inflated balloon tamponades bleeding in the posterior nares. The authors are from the University of Manchester.
Patient selection: epistaxis due to a posterior bleed
The Foley catheter is used to tamponade the posterior nares and a gauze-based pack is placed anterior to this. The process is considered successful if post-natal bleeding is eliminated.
A size 12 Foley with a 30 mL balloon is recommended. The balloon is filled with water or saline.
The authors recommend initially inflating the balloon with half the required fluid then pulling the catheter out so that it wedges in the posterior choana. After wedged successfully the remainder of the inflating fluid is injected. Filling the balloon first makes wedging more difficult and painful for the patient.
Traction is applied by placing a short length of plastic suction tubing over the catheter and snugging it down against the packing in the anterior nares. The assembly is secured with an umbilical or screw clamp.
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