So your next patient has a good sized avulsion off the pad of his finger that’s still oozing despite his attempts at direct pressure.
You also can’t find your Surgicel, and your patient hates needles. You still have the lidocaine with epi in your pocket from when you thought you’d get to stitch something up, though. Can we use this another way?
soak something (cotton ball/tip, gauze, etc) in epi, then mash it against the thing that’s bleeding
epi (which also comes handily pre-mixed with lidocaine anesthetic in nice dilute doses) is a vasoconstrictor
-> better opportunity for platelets to not get swept away and form clot
dilute concentrations applied topically would seem to have less risk for harm than direct infiltration
quick Pubmed/internet biopsy is interesting, if with limited data:
- delivery methods included epi + KY, epi-spray, sub-cut infiltration
- epi achieved hemostasis faster than thrombin, saline, or mineral oil
other random discoveries:
- lido + epi cotton balls shorted time to hemostasis in rabbit epistaxis
- epi-soaked gauze reduced mean # of packings, cautery use, and procedure time in kids getting adenoidectomies
- gauze-soaked epi used for tissue and gallbladder fossa hemostasis during a lap chole
- suggested for hemostasis in circumcision (just don’t leave it on too long)
- epi-soaked cotton products for dental procedures (just search the interweb “cotton epinephrine hemostasis”)
mostly studied for ENT uses, but seems to help wound hemostasis
probably worth a shot. keep it in your toolbox.