Practical Pointers: Nosebleeds, Abscess Draining, Foreign Bodies, Thyroid Exam Discomfort

Surefire Solution for Nosebleeds The next time a young patient presents with epistaxis, try this approach. Thoroughly soak several cotton balls with phenylephrine, and pack them in the bleeding nostril. The cotton balls act as packing and the phenylephrine helps stop the bleeding by constricting the ruptured blood vessels. — Ben Edwards, MD China Spring, Tex ____________________________________________ Extracting a Foreign Body A dermatologic comedone extractor is an excellent tool to aid in the removal of fine foreign bodies, such as cactus needles, small splinters, and insect stingers, that are embedded in the skin. Place the extractor over the area, with the foreign body centered in the tool’s open circle. Make sure the extractor is angled in the direction of the foreign object, and press down as firmly as necessary. The circular compression created around the foreign body will cause it to rise through the extractor’s hole. — John D. Bayer, DO Greencastle, Pa _____________________________________________ Suck It Out The use of suction can help you avoid the unpleasant odor and splatter that often occur during abscess drainage. After incision, use a Yankauer suction handle with bulbous tip to probe the abscess and drain the pus. This technique makes the procedure much easier on the nose and ensures that no “mystery fluid” will be left on your clothes. — Susan Creal, PA-C Lincoln, Neb ______________________________________________ Wash Away Thyroid Exam Discomfort Offer patients a glass of water when you ask them to swallow during a thyroid examination. This makes it easier for them to swallow naturally, and thus makes it easier for you to evaluate the thyroid gland. — Chuen-Yen Lau, MD Bethesda, Md