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General product information only. This page is not medical advice and does not describe how to place, adjust or remove a pack; those decisions belong to a trained clinician.
Short answer
A nasal tampon is a pack placed in the nose to press on a bleeding site in an anterior nosebleed (epistaxis). “Nasal packing” is the umbrella term: it covers compressed sponge tampons, inflatable balloon tampons and older ribbon gauze. In the United States, the balloon type has its own FDA product code (EMX), is Class I and is exempt from 510(k) premarket notification.
Definition and scope
The terms are used loosely, so it helps to separate them. According to the Royal College of Emergency Medicine learning module on nasal packing (checked 2026-10-30), anterior packs fall into two modern types plus one traditional type: compressed sponge tampons, inflatable balloon tampons, and ribbon gauze soaked in bismuth iodoform paraffin paste (BIPP). The module describes the gauze as the traditional option that has been superseded by nasal tampons.
This page covers anterior nasal packs as supplies. It does not cover posterior packing, nasal splints used after surgery, or the management of bleeding itself. A nasal splint is a different product with a different purpose; see the separate guide to the nasal splint. “Nasal tampon” also has no connection to the menstrual product of the same word.
How the pack types are described in clinical sources
Compressed sponge tampons (Merocel, Rhino Rocket)
The RCEM module names Merocel and Rhino Rocket as examples. These are supplied compressed and expand once wetted. It states that a Merocel pack is “as effective and comfortable as a traditional ribbon gauze” and “far easier to insert”. “Merocel nasal pack” is therefore a brand name for this sponge type, not a separate category.
Inflatable balloon tampons (Rapid Rhino, nasal balloon)
The same module names Rapid Rhino as the example of an inflatable balloon tampon, filled with air rather than liquid. It reports that Rapid Rhino is as effective in controlling epistaxis as a compressed sponge tampon, with less pain on insertion and easier removal. “Nasal balloon” and “epistaxis balloon” describe this type in general terms.
Ribbon gauze and dissolvable packs
BIPP-soaked ribbon gauze is the older method. A 2017 systematic review in the Journal of Laryngology and Otology (Iqbal et al., 27 articles on non-dissolvable packs and 9 on dissolvable packs) found higher re-bleed rates with BIPP packing than with Rapid Rhino or Merocel. It describes the evidence on dissolvable packs as limited.
Comparison of the pack types, by source
| Type | Examples named in sources | What the sources say |
|---|---|---|
| Compressed sponge tampon | Merocel, Rhino Rocket (RCEM) | Supplied compressed and expands once wetted (RCEM). Re-bleed rates similar to Rapid Rhino (Iqbal et al. 2017). |
| Inflatable balloon tampon | Rapid Rhino (RCEM) | Inflated with air (RCEM). Reported to have efficacy equivalent to nasal tampons (Iqbal et al. 2017). |
| Ribbon gauze with BIPP | Not branded (RCEM) | Traditional method, superseded by tampons (RCEM). Higher re-bleed rates than Rapid Rhino or Merocel (Iqbal et al. 2017). |
| Dissolvable packs and haemostatic agents | FloSeal (named in the review) | Evidence on dissolvable packs is limited (Iqbal et al. 2017). |
Where it matters for labs, clinics and supply decisions
The regulatory record a buyer can check
Clinical pages rarely state how these products are regulated. The FDA Product Classification database (checked 2026-10-30) lists product code EMX, device name “Balloon, Epistaxis”, Class 1, under 21 CFR 874.4100, in the Ear, Nose and Throat specialty. The same record marks the code as 510(k) exempt but not exempt from good manufacturing practice requirements, and eligible for summary malfunction reporting.
The regulation itself (21 CFR 874.4100, checked 2026-10-30) identifies an epistaxis balloon as “a device consisting of an inflatable balloon intended to control internal nasal bleeding by exerting pressure against the sphenopalatine artery”. It classifies the device as Class I (general controls), exempt from premarket notification subject to 21 CFR 874.9. That entry describes balloons; this page does not claim that sponge tampons fall under the same code.
The same FDA record shows that 510(k) exemption is not the same as exemption from every requirement: the good manufacturing practice exemption is marked “No”. For the terms used around these records, see the CASRAI entries on FDA registered establishment, medical device reporting and the FDA.
What the evidence review does and does not settle
- Efficacy of Rapid Rhino and nasal tampons was found equivalent, and re-bleed rates for Rapid Rhino and Merocel were similar (Iqbal et al. 2017).
- The review found a lack of evidence on the economic effects of pack choice and on the appropriate care setting for non-dissolvable packs (Iqbal et al. 2017).
The practical reading for anyone comparing supplies is that the published evidence does not rank sponge and balloon tampons on effectiveness. Product details are set out in the manufacturer’s instructions for use, which this page does not supply.
Common misunderstandings
- Packing is not one product. It is the umbrella for sponge, balloon and gauze methods.
- A nasal splint is not a nasal pack. Splints support the nose after surgery; packs are used for bleeding.
- Class I is a regulatory class, not an effectiveness ranking. In the FDA record it attaches to the balloon device code (EMX) and means general controls.
FAQ
What is the difference between a nasal tampon and nasal packing?
Nasal packing is the general term for any material placed in the nose for a nosebleed. A nasal tampon is one modern form of it, either a compressed sponge or an inflatable balloon.
Is Rapid Rhino a nasal balloon?
Yes. The RCEM module lists Rapid Rhino as an inflatable balloon tampon, inflated with air.
Is a Merocel nasal pack the same as a balloon?
No. RCEM groups Merocel with compressed sponge tampons, which are supplied compressed and expand once wetted, whereas balloon tampons are inflated with air.
What is the FDA class of a nasal balloon?
The epistaxis balloon (product code EMX, 21 CFR 874.4100) is Class I and exempt from premarket notification, per the FDA classification database and the regulation text.
Sources
- U.S. FDA, Product Classification, product code EMX (Balloon, Epistaxis): accessdata.fda.gov, checked 2026-10-30.
- 21 CFR 874.4100, Epistaxis balloon: law.cornell.edu/cfr/text/21/874.4100, checked 2026-10-30.
- Royal College of Emergency Medicine, RCEM Learning, Nasal Packing: rcemlearning.co.uk, checked 2026-10-30.
- Iqbal IZ et al. Intranasal packs and haemostatic agents for the management of adult epistaxis: systematic review. J Laryngol Otol 2017;131(12):1065-1092. doi:10.1017/S0022215117002055, abstract checked 2026-10-30 via PubMed (PMID 29280695).
