In our department, it is a routine procedure to tamponade the bleeding nasal cavity for 5 to 10 minutes with a cotton or gauze mesh embedded with a solution of phenylephrine hydrochloride and tetracaine. This is done to obtain some degree of hemostasis and local anesthesia before inspection of the nasal cavity at the initial contact with the otolaryngologist on call. This measure provides an opportunity to detect the source of the nosebleed for possible cauterization in case of anterior bleeding or, if the source of bleeding cannot be visualized, to facilitate the final tamponade with as little pain as possible.
Stangerup S. Hot-Water Irrigation in the Treatment of Posterior Epistaxis—Reply. Arch Otolaryngol Head Neck Surg. 1999;125(11):1285. doi: