Athletic Use Epistaxis Treatment DeviceWenyan Zhu*, Stephen Jarrett*, Michelle Pinson*, Denis Rowe‡

*Vanderbilt University Biomedical Engineering Department‡Arthron Inc.

AbstractEpistaxis or nasal bleed is an acute hemorrhage occurring in the nasal cavity or surrounding nasal structures. Everything from tissue paper to an over-the-counter twelve dollar device can be used to correct this problem. This project focuses on building a comfortable, absorbent, easy-to-use nose plug that remains cost efficient for high school budgets. Interviews were conducted to determine the project specifications, a market analysis was completed to assess the competition, nose size measurements were taken to determine the correct fit, and a prototype built from this information. It is currently in the process of being FDA- approved and manufactured by an outside vendor.

Introduction

ObjectivesTo design an ideal treatment that can be used when a patient suffers from a nosebleed, clinically known as epistaxis. It must be the following:

•Easy to insert and remove•Cost efficient•Comfortable•Absorbent•Ideal material to stop bleeding (fabric vs. gel vs. powder)

Epistaxis, commonly known as a nosebleed, is clinically defined as the “acute hemorrhage from the nostril, nasal cavity, or nasopharynx.” Epistaxis is broken down into two categories, anterior verses posterior. The anterior epistaxis, seen in Figure 1, occurs in a region known as the Kiesselbach’s plexus, “a strip about 1.5 mm wide covering a region of capillary corps that are unusually wide and long” where “even mild trauma to this area can cause bleeding, especially in childhood”. Epistaxis can occur for a variety of reasons including during the winter the nasal membranes dry out, crust, and crack as a result of the dry and warm air from heaters, direct trauma, nose picking, surgery, external forces, or pressure changes, or indirect trauma, such as vascular forces (arteriosclerosis or hypertension), hematological disorders (primary blood diseases or an anticoagulant drug), inflammatory conditions (allergies), or hormonal factors. Current treatments include sponges (Figure 2) as well as application of powders and gels, basic cotton tampons, gauze, and tissue paper many of which are not effective or too expensive. All of these have positives and negatives, so it is imperative to find a cost efficient alternative for high school budgets that is still effective

Methods

Discussion & Results

Conclusions

Recommendations•Proper volunteer testing needs to be completed with the final manufactured product•A vasoconstrictor that is already approved for FDA use over the counter must be found to apply to the vasoconstrictor version of the nose plug•Proper advertising must be conducted•A finalized way to apply the vasoconstrictor without losing absorbency must be found and utilized•More research should be conducted on types of vasoconstrictors that can be used on open wounds

References Economic Analysis

•Market: •Athletes (wrestlers especially)

•FDA approval Cost: TBD•Manufacturing Cost: TBD•Selling price of Nose plug: $0.50

•w/ vasoconstrictor: $1.00•Costs of goods sold per device:

•Cotton: $ .08•Packaging: $ TBD•Other: $ TBD

•Rowe, Denis•Johnson, Michelle•Davis, Brian•Hall, Reagan

•Lang, Johannes. Nasal Cavity and Paranasal Sinuses. Translated by P.M. STell. Publisher Thieme

•Refinement of this device to a final manufactured product provides a successful solution to the cost and effectiveness issues currently faced by nosebleeds suffered in high school wrestling.•The final stages of this design process have been reached and the process has been beneficial and successful•Arthron and third party manufactures will continue any future development•Further testing will required the finished design from a manufacturer •To complete design process, third party support must be obtained for proper design and testing

Prices of Noseplugs

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The treatment of wrestling nosebleeds by the athletic trainers is simple: first, the excess blood is wiped off, next some sort of a treatment, or nose plug, is inserted, usually with the aide of petroleum jelly, and then the treatment is left in for at least 10 minutes. The insertion is done with the fingers, either by the ATC or the athlete. After the nose plug is inserted, the athlete can return to his activities, many times finishing a match. As soon as the nosebleed is treated, the athlete is allowed to compete once more. Even though the bleeding stops within the first ten minutes, the nose plug is removed later on, usually after the tournament, by either the ATC or the wrestler himself.

Normal tampons, when treated with a liquid, open in two ways (Fig 3 and 4). Because of the form fitting nature of Fig 3. We decided to use a similar result when liquid is added to our device.

The key part of product specification was determining the size of the nose plug. To properly accomplish this, the size of the nose must be scientifically calculated or measured. This was done using properly zeroed calipers and resulted in an average nostril size of 13.03 mm wide and 15.3 mm deep. This result was averaged out to creature a cylindrical prototype (Figure 5) with a 14 mm width and depth. This was done to simplify usage and ease the process of weaving the cotton.