Topical intranasal corticosteroid therapy in rhinitis

At the Everest base camp medical clinic, conditions are cold and hostile, nearly every case is urgent, and routine treatment we rely on in urban hospital environments is sometimes impossible to carry out.  Having the ability to administer medications intranasally, obviating the need for IV access (and thawing out of our IV fluids!) can be not only an easier and timelier solution, but downright lifesaving!  In our recent 2008 season, our staff had the opportunity to treat a brisk nosebleed patient by administering intranasal oxymetazoline and lidocaine to facilitate insertion of a posterior packing device.   We have our nasal drug delivery systems at the ready to administer midazolam, metoclopramide, glucagon, naloxone and opiates if the need arises as well... Luanne Freer, MD -  Medical Director of Everest Base camp, Medical Director Yellowstone .

 
Normal Nasal Mucosa and Ostea of Maxillary Sinus : Click on pictures to enlarge !!!    
Foreign Body in the Nose:   This picture shows a plastic "hot wheels" toy in the right naris of a 5 year old.  The foreign body is wedged below the middle turbinate .  Attempts at removal in the emergency room was unsuccessful and the child was taken to the operating room for removal. 




Click on pictures to enlarge !!!    
This picture shows a wood chip foreign body in the nose.  It is located under the middle turbinate , deep in the middle meatus .  It was removed in the doctor's office under local anesthesia. 
Click on pictures to enlarge !!!    
Epistaxis :  Search PubMed for Epistaxis This picture shows prominent anterior (up-front) septal vessels which will bleed easily.  This type of nose bleed ( epistaxis ) usually occurs in children.

Topical intranasal corticosteroid therapy in rhinitis

topical intranasal corticosteroid therapy in rhinitis

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