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

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

J Laryngol Otol. 2017 Dec;131(12):1142-1156

Authors: INTEGRATE (The National ENT Trainee Research Network)

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.

PMID: 29280691 [PubMed - in process]

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