Treatment of primary hemorrhage is first attempted
on the ward by suction removal of persistent
clots, application of pressure with a sponge
soaked in adrenalin and bismuth subgallate to the
bleeding area, instillation of phenylephrine hydrochloride
into the nasopharynx or silver nitrate
cauterization of the bleeding points. This approach
was successful in 97% of cases; however, in 10%
of those in which bleeding was initially controlled
hemorrhage recurred and required repetition of the
procedure. Six of the 202 patients (0.06% of all the
patients) required a second general anesthetic for
hemostasis (Table I). One of these patients and five
others required blood transfusions.