Relative contraindications Severe nasal septal deviation toward bleeding side (makes it difficult to insert tamponade material) Complications Injury to the nasal mucosa including pressure necrosis with possible septal perforation, particularly with bilateral nasal packing Migration of anterior nasal packing to the posterior nasopharyngeal area or aspiration into the airway Infections such as sinusitis or rarely toxic shock syndrome Rebleeding when pack is removed Equipment Gloves, mask, and gown Gown or drapes for patient Suction source and Frazier-tip and / or other suction-tip catheters Tamponade device or material * Emesis basin Chair with headrest or an ear, nose, and throat (ENT) specialist's chair Light source and head mirror or headlamp with adjustable narrow beam Nasal speculum Tongue depressors Bayonet forceps Scissors for cutting nasal gauze or tampons Antibiotic ointment (bacitracin) 5-mL sterile saline solution Topical anesthetic / vasoconstrictor mixture (eg, 4% cocaine, 1% tetracaine or 4% lidocaine plus 0.5% oxymetazoline) or topical vasoconstrictor alone (eg, 0.5% oxymetazoline spray) Cotton swabs or pledgets * There are several types of tamponade material / devices: Compressed polyvinyl acetate nasal tampon (sometimes with an internal airway tube), ideally with removal strings that can be secured to the patient's cheek to prevent aspiration and aid removal High-volume, low-pressure inflatable ballon tampon with an air passage and a carboxymethylcellulose (platelet aggregating) covering 1.25 cm (½-inch) petrolatum gauze strip, 180 cm (72 ") long Nasal tampons are highly compressed for ease of insertion; they expand and become soft when hydrated.