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Epistaxis is the most common presentation to acute ENT services in the UK. However, there are currently no nationally accepted guidelines for its management. The British Rhinological Society, ENT UK and INTEGRATE (The National ENT Trainee Research Network) are working together to deliver a national prospective audit of practice for the hospital management of epistaxis. Here, Andy Hall tells us more.

 

As a first step in this process, the INTEGRATE committee organised an ‘Epistaxis Consensus Day’ which demonstrated the value of a multidisciplinary, multi-centre collaboration. Fifteen trainee-delivered systematic reviews were presented on epistaxis, looking at areas of controversy ranging from initial assessment to the type of intervention. A total of 49,521 articles were screened, creating a detailed summary of the current best available evidence.

 

Figure 1: British Rhinological Society President, Sean Carrie, introducing the day’s proceedings.

 

What became apparent was that delivery of a seemingly impossible task was completed through the dedicated involvement of many individuals, each working on a distinct area of importance to the project. When these were brought together, a substantial body of work emerged, which bodes well for future collaborative endeavours.

These evidence-based findings were then placed under the scrutiny of a multidisciplinary panel of experts from across the UK with expertise in the fields of emergency medicine, general ENT, rhinology, radiology and haematology as well as patients themselves. This led to lively debate, with recognition that much can be done to strengthen our clinical decision making and ultimately improve the patient experience.

“Delivery of a seemingly impossible task was completed through the dedicated involvement of many individuals, each working on a distinct area of importance to the project.”

Figure 2: Members of the expert panel debate the evidence presented.

 

Figure 3: Members of the INTEGRATE Committee. “Delivery of a seemingly impossible task was completed through the dedicated involvement of many individuals, each working on a distinct area of importance to the project.”

 

Subsequently, ENT UK has sponsored a two-cycle national audit, which seeks to assess current practice and improve our understanding of this condition. Through delivering this ambitious project, INTEGRATE hopes to continue to build the foundations for ongoing trainee collaborative research within our specialty. This model has shown great success in other surgical specialties, with good quality research and audits leading to high impact publications. We believe collective enthusiasm harnessed towards a common goal has the ability to result in the delivery of this and future projects in ENT.

The first cycle of the prospective national audit commences in November 2016. We wish to involve as many trainees in as many hospitals as possible within the UK to give a true representative snapshot of current practice. To represent your hospital and find out more, please visit www.entintegrate.org



Declaration of Competing Interests: None declared.

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CONTRIBUTOR
Andy Hall

FRCS (ORL-HNS), North Thames, ST7 Northwick Park Hospital, London, UK.

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