740 Improving the Management of Epistaxis in Clinical Practice

Abstract

Abstract Aim Improving the standard of epistaxis management in Ayrshire & Arran. Method A survey was distributed to doctors assessing their familiarity with epistaxis assessment and management. Working with the ENT department, a teaching programme was then developed aimed at improving skill in nasal packing, cautery and first aid, based on local guidelines. After the first session, all participants filled in a post-education questionnaire and results collated. Results The survey collected information throughout Ayrshire & Arran, from 21 doctors across 10 different specialities, ranging from Foundation, Clinical Fellows, and Core Trainee's. Using a rating of one to five, least confident to most confident respectively. 95% of participants chose between one and three when asked about independently managing epistaxis, which significantly reduced to 0%. 52% of participants chose ‘least confident’ with familiarity of nasal packing and nasal cauterisation, reducing to 0%. In addition, 40% of doctors were unfamiliar with options for packing, which increased to 100%. Conclusions Epistaxis is one of the most common acute ENT presentations. 86% of cases will be initially managed by junior doctors using first aid management, packing, or cauterisation. This is not taught as standard in undergraduate or postgraduate education. Currently, there are no nationally accepted guidelines for its management, regardless of its high presentation, readmission, and mortality rate. There is an observable gap in epistaxis education, crucial when considering majority of its’ management will be handled by junior doctors. We have seen an increase in participants confidence and familiarity of the condition which merits running this teaching programme.