Q: 63 year old male in ICU recovering from pneumonia, developed severe epistaxis. As a a first measure, you applied pressure over the nose. What other maneuver beside applying pressure may help in epistaxis?


Answer:  Tilting the head forward

In severe epistaxis along with applying pressure, tilting the head forward not only decreases the danger of airway obstruction, it also decreases the chance of vomiting (which may cause aspiration pneumonia) - as swallowed blood can irritate the stomach.



Reference: 

 Corry J. Kucik; Timothy Clenney (January 15, 2005). "Management of Epistaxis". American Academy of Family Physicians. Retrieved January 31, 2010.