EMERGENCY ROOM REPORT
He was brought to the emergency room with a right epistaxis with clots in the nose. Patient is on Coumadin.
EXAMINATION: Clots were removed from the right nostril, and an active venous bleeder on the right anterior septum was identified. This was cauterized with silver nitrate and an anterior pack placed. The left side appeared to have no active bleeding. He was observed for a few minutes, and no further bleeding of an active nature was identified. Some tape as couterpressure was applied to the nose, and the throat checked also. There is just an old clot posterior that’s sticking down just enough so that you can see it but cannot reach it with an instrument. This was left in place. I recommend that we leave the pack in until Wednesday morning if patient tolerates it. He is apparently already on antibiotics, pain medicines, and oxygen, so no additional orders are indicated at this time.
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