Just had the worst nose bleed yet. 76 y female on coumadin - slowly bleeding to death - Cautery of anterior bleed successful > until I discovered the posterior bleed. - Merocel > FAILED, bled right through it. - Epimax 2 balloon nasal catheter, still OOZING. - Ativan & Haldol > Pt still touching her nose - messing with the catheter. - FFP reversal of INR > still OOZING - RBC transfusion > pt develops skin rash - 3 calls to the ENT > "I'm not coming in." - 4th call to the ENT & We're thinking about intubating > "I'll be right there." - ENT arrives, deflates and removes the Epimax > BLEEDING STOPS!!!!!!!!! - Who's the putz? > Me. No more, please! I'd rather poke myself in the eye with a hot poker.