• Bi Wen Lau and Alex Paspaliaris.
• Latrobe Regional Hospital, 10 Village Ave, Traralgon, VIC 3844, Australia; Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia. Electronic address: biwen.lau@monashhealth.org.
• Am J Emerg Med. 2018 Jul 1; 36 (7): 1322.e3-1322.e4.

AbstractEpistaxis is commonly managed with RapidRhino in emergency departments. We report a case of RapidRhino herniation during air inflation in a 99-year-old female, leading to significant airway obstruction. Upon re-inflation of the RapidRhino for persistent epistaxis, our patient suddenly developed acute respiratory distress. Throat examination revealed a large clot-like circular mass occluding the oropharynx. Initially mistaken as a massive blood clot, the mass was identified as the distal end of the RapidRhino. Immediate deflation of the RapidRhino results in spontaneous resolution of the respiratory distress. We hypothesise that the RapidRhino has herniated posteriorly into the oropharynx through excessive air inflation, potentially compounded by a product defect. Our case highlights a fatal consequence of RapidRhino application where emergency physicians should be cautious of, especially among inexperienced users.Copyright © 2018 Elsevier Inc. All rights reserved.

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