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Lookup NU author(s): Sean Carrie
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© 2017 JLO (1984) Limited. 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.
Author(s): INTEGRATE (The National ENT Trainee Research Network)
Publication type: Article
Publication status: Published
Journal: Journal of Laryngology and Otology
Year: 2017
Volume: 131
Issue: 12
Pages: 1142-1156
Print publication date: 31/12/2017
Online publication date: 27/12/2017
Acceptance date: 24/07/2017
ISSN (print): 0022-2151
ISSN (electronic): 1748-5460
Publisher: Cambridge University Press
URL: https://doi.org/10.1017/S0022215117002018
DOI: 10.1017/S0022215117002018
PubMed id: 29280691
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