Adrenaline cotton swab in nose packing for epistaxis mode of action
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epistaxis nasal packing topical adrenaline epinephrine mechanism vasoconstriction guideline
An adrenaline (epinephrine)-soaked cotton swab or pledget helps control epistaxis mainly by local vasoconstriction.
- Mechanism: Adrenaline stimulates alpha-1 adrenergic receptors on arteriolar smooth muscle in the nasal mucosa.
- Result: Constriction of mucosal arterioles reduces blood flow to the bleeding vessel, rapidly decreasing bleeding and making the bleeding point easier to see.
- The swab also provides direct pressure, which adds mechanical tamponade and supports clot formation.
It is generally a temporary measure before definitive treatment such as cautery or formal nasal packing if bleeding persists. Topical vasoconstrictors are used as adjuncts to sustained nasal compression in epistaxis management, as described in the MSD epistaxis procedure guide.
Caution: Excess absorption can cause palpitations, tachycardia, hypertension, or arrhythmias, particularly with high concentrations, prolonged contact, or in patients with cardiovascular disease.
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