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

W. Adams, S. Carrie, R. Cathcart, P. Chatrath, M Ellis, A. Hall, J Hardman, Colin R. Hopkins, R. Lenthall, J. Mainwaring, N. Mehta, P. Nankiwell, T J C Nokes, P. Nix, C. Philpott, A. Reuben, R J Salib, N. Sharma, M. E. Smith, P. SuraA Sutton, V M M Ward, Paul White, R. Williams (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

33 Citations (Scopus)


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
JournalJournal of Laryngology and Otology
Issue number12
Publication statusPublished - 1 Dec 2017


  • Assessment
  • Cautery
  • Epistaxis
  • Hematology
  • Packing
  • Surgery

ASJC Scopus subject areas

  • Otorhinolaryngology


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