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FIGURE 1 Using the mucosal atomization device (MAD).
          (A) MAD package and device next to a 5mL syringe. (B) Application of MAD to left nare; patient is in the proper, upright “sniffing” position.
          (C) Initial atomized mist using MAD. (D) Mid-stream atomized mist using MAD.

              (A)                                               (B)




































                (C)                                                   (D)

































            4.  Gilman, C. Treatment of epistaxis. ACEP Now. June 2009.     6.  Zahed R, Jazayeri MHM, Naderi A, et al. Topical tranexamic
             https://www.acepnow.com/article/treatment-epistaxis/?single   acid compared with anterior nasal packing for treatment of
             page=1/                                            epistaxis in patients taking antiplatelet drugs: randomized
            5.  Zahed R, Moharamzadeh P, AlizadehArasi S, et al. A new and   controlled trial. Acad Emerg Med. 2018;25(3):261–266.
             rapid method for epistaxis treatment using injectable form of     7.  Utkewicz MD, Brunetti L, Awad NI. Epistaxis complicated
             tranexamic acid topically: a randomized controlled trial. Am   by rivaroxaban managed with topical tranexamic acid. Am J
             J Emerg Med. 2013;31(9):1389–1392.                 Emerg Med. 2015;33(9):1329. e5-7.


          26  |  JSOM   Volume 19, Edition 2 / Summer 2019
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