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Inserting anterior nasal packing

Inflatable Balloon Device

An inflatable balloon device has a balloon that’s coated with a carboxymethylcellulose hydrocolloid compound, which acts as a platelet aggregator. The substance also creates a lubricant when it comes in contact with water to ease insertion. After soaking the device in sterile water, the practitioner inserts the device along the superior aspect of the hard palate until the fabric ring is well into the naris (as shown below). Then, using a 20-mL syringe, the practitioner inflates the balloon until the pilot cuff becomes rounded and feels firm when squeezed. 27

Reassess the device 15 to 20 minutes after insertion. If necessary, reinflate the cuff to ensure proper pressure. Tape the pilot balloon to the patient’s cheek away from the upper lip. The device can remain in place for up to 72 hours, as needed. 30

Nasal Tampon

To insert a nasal tampon, after coating the tampon with water-soluble lubricant or antibiotic ointment, as prescribed, the practitioner grabs the string end with gloved fingers or forceps. The practitioner inserts the tampon gently and quickly along the floor of the nasal cavity until the string reaches the naris (as shown below).3

If the tampon doesn’t expand within 30 seconds of insertion, the practitioner irrigates it with 10 mL of saline solution or water so that the tampon expands. Tape the string to the patient’s nose to secure the device in place, and trim the ends of the string, if necessary.