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

  • INTEGRATE (The National ENT Trainee Research Network) (a1)
  • Please note a correction has been issued for this article.

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.


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.


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).


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.

Corresponding author
Address for correspondence: Mr Richard Williams, Institute of Naval Medicine, Crescent Rd, Alverstoke, Gosport PO12 2DL, UK E-mail:
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
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