First Haemostatic Measure — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyOral SurgeryFirst Haemostatic MeasureORE Part 1

A 55-year-old patient on long-term warfarin (INR 2.8) undergoes extraction of an upper premolar. Immediately after extraction, there is brisk bleeding from the socket. What is the FIRST local haemostatic measure?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Apply firm pressure with a damp gauze pack over the socket for 15–20 minutes

Answer D is correct. Firm gauze pressure for 15–20 minutes is the established first-line local haemostatic technique for post-extraction socket bleeding, supported by SDCEP guidance and NHS protocols. In anticoagulated patients with INR ≤ 3.0, pressure alone controls bleeding in the majority of cases. Option C (oxidised cellulose without pressure) is passive and represents a secondary measure if compression fails. Option E (immediate suturing) bypasses the simpler and more effective initial step. Option A (tranexamic acid mouthwash discharge) is inappropriate during active brisk bleeding and ignores the need for immediate local control. Option B (topical adrenaline) is not standard UK dental haemostatic practice for socket bleeding.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd Edition. https://www.sdcep.org.uk/media/ypnl2cpz/sdcep-management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs-2nd-edition.pdf (2023). Combined with NHS emergency dental haemorrhage protocol and peer-reviewed evidence (Bajkin BV et al., J Am Dent Assoc 2015; indexed PubMed 25638996).