The British Rhinological Society multidisciplinary consensus recommendations on the hospital management of epistaxis

Research output: Contribution to journalArticlepeer-review



OBJECTIVE: Epistaxis is a common ENT emergency in the UK; however, despite the high incidence, there are currently no nationally accepted guidelines for its management. This paper seeks to recommend evidence-based best practice for the hospital management of epistaxis in adults.

METHODS: Recommendations were developed using an Appraisal of Guidelines for Research and Evaluation ('AGREE II') framework. A multifaceted systematic review of the relevant literature was performed and a multidisciplinary consensus event held. Management recommendations were generated that linked the level of supporting evidence and a Grading of Recommendations Assessment, Development and Evaluation ('GRADE') score explaining the strength of recommendation.

RECOMMENDATIONS: Despite a paucity of high-level evidence, management recommendations were formed across five management domains (initial assessment, cautery, intranasal agents, haematological factors, and surgery and radiological intervention).

CONCLUSION: These consensus recommendations combine a wide-ranging review of the relevant literature with established and rigorous methods of guideline generation. Given the lack of high-level evidence supporting the recommendations, an element of caution should be used when implementing these findings.


Original languageEnglish
Pages (from-to)1142-1156
Number of pages15
JournalThe Journal of laryngology and otology
Issue number12
Publication statusPublished - Dec 2017


  • Epistaxis/therapy, Evidence-Based Medicine, Hospitalization, Interdisciplinary Communication, Intersectoral Collaboration, Medical Audit, Otolaryngology, Patient Care Team, Quality Assurance, Health Care, Societies, Medical, United Kingdom