Epistaxis is a common and potentially life threatening sequela of facialtrauma. We present a two case series of patients who suffered significantintracranial and intraorbital injuries as a result of insertion of nasalcatheters in the setting of epistaxis and severe facial trauma. Insertion ofintranasal devices to control epistaxis in the presences of facial traumashould be used as a last resort. The potential for iatrogenic complicationsshould always be considered in this setting. We offer suggestions forepistaxis management and a brief review of the literature.