Abstract
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 language | English |
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Pages (from-to) | 1142-1156 |
Number of pages | 15 |
Journal | The Journal of laryngology and otology |
Volume | 131 |
Issue number | 12 |
DOIs | |
Publication status | Published - Dec 2017 |
Keywords
- Epistaxis/therapy
- Evidence-Based Medicine
- Hospitalization
- Interdisciplinary Communication
- Intersectoral Collaboration
- Medical Audit
- Otolaryngology
- Patient Care Team
- Quality Assurance, Health Care
- Societies, Medical
- United Kingdom