Cardiac arrest after severe epistaxis

Nasal bleeding frequently leads to admissions to the Emergency Department (ED), with anterior nasal packing being a common treatment approach. Our patient was transferred to the ED from a nursing home due to epistaxis, which was already initially managed by nasal packing. Upon arrival at the ED he suffered Cardiopulmonary Arrest (CA) with an initial CA rhythm of Pulseless Electrical Activity (PEA). Advanced Life Support (ALS) was initiated immediately according to the ERC guidelines. Upon intubation, a nasal gauze was aspirated from the endotracheal tube, and approximately ten minutes later, Return of Spontaneous Circulation (ROSC) was achieved. Subsequently, the patient was transferred to the Intensive Care Unit (ICU). Unfortunately, despite medical intervention, the patient succumbed to complications days later. The dislodgement of nasal packing leading to asphyxiation represents a rare but potentially fatal complication of this procedure. Healthcare providers should be vigilant and prepared to promptly address such complications as they arise.