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

INTEGRATE (The National ENT Trainee Research Network) (2017) The British Rhinological Society multidisciplinary consensus recommendations on the hospital management of epistaxis. The Journal of Laryngology & Otology, 131 (12), 1142-1156. (doi:10.1017/S0022215117002018).

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.

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Contributors

Author: W. Adams

Author: R. Salib

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