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by four, you can roll it up, pick it up, the nose. Like football, we used to use tampons. Same thing. That's what a tampon's for, right? But you put it in the nose. The worst thing is the patients that you see with a nosebleed, and they do that. Oh. What are they doing every time they do that? They're pulling the frigging clot out. Leave it in place. Stop pulling it away. Oh, there goes another clot, and another clot. Leave it in place. The office I'm in, we've seen some interesting stuff come out of people's noses after nosebleeds. It's ENT, so we're doing a lot of that stuff. My favorite thing for nosebleeds is silver nitrate. Oh, yeah, that'll work. The only other thing you have to do is cauterization. Cauterization, they use an actual cauterizing tool like a surgical tool. You go in and you cauterize the place. I had a friend one time whose daughter, she was about six, and he called me down. He said, Greg, Greg, I don't know what to do. Can you come down? And she was sleeping. She's got a nosebleed during her sleep. And it actually went through the mattress and puddled on the floor, on the floor. And that's a lot of bleeding. She ended up getting a cauterization there. Blast injuries to the nose may be associated with fractures and soft tissue injuries to the head, face, or other injuries. So, obviously, the nose is kind of an area of sensitivity. As we look here, these are the turbinates. The contra bones are underneath, and they produce these turbinates that make the air turbulent. And then you have the goblet cells that release mucus, plus the air, help filter, humidify, and warm the air we breathe. But you can see, and these are the sinuses, the sinuses, your skull. If you didn't have sinuses, your skull would be 40% heavier. And you'd also have a very funny voice. Our sinuses make our skull lighter with the same strength, but also allow us to give the resonance of our voice. That's why you can't call me, because your sinuses get blocked. But, if you look at it, look at how thin some of those bones are. And this is the skull right here, this is the brain right here. So, look at how we put it. This is the brain right in through here. So, look at how the shape of the skull. Some of those bones are very thin. This is where you get the basilar skull fracture. This is why you don't put an NPA in head trauma. Because if this is fractured, it would go right up in there. And that's the brain right there. Patients with severe nasal injuries may have cervical spine injury too, especially in assault. Somebody was assaulted, they got a nasal fracture or maxillofracture because they were punched in the face. They could have cervical spine injury as well. Cerebral spinal fluid may escape down the nose following a fracture of the basilar skull. Especially if it impacts the face. If you've got a bloody, clear, or pinkish fluid coming out of the nose after head trauma, consider that the potential of a basilar skull fracture. What can we do? How do we test that? Halo testing. Halo testing. Halo testing. A 4x4, grab it on the bloody liquid, put it off to the side, and then go check it. If you have a dot of blood which is surrounding halo of yellow fluid, that is positive halo test. That's a positive sign of a basilar skull fracture. Let me take five minutes. We're almost done with the lecture. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. Let's take five minutes. 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