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

INTEGRATE (The National ENT Trainee Research Network), Paul Nankivell

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

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 languageEnglish
Pages (from-to)1142-1156
Number of pages15
JournalThe Journal of laryngology and otology
Volume131
Issue number12
DOIs
Publication statusPublished - 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

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