Epistaxis

Can trainees design and deliver a national audit of epistaxis management? A pilot of a secure web-based audit tool and research trainee collaboratives (2017)

Posted on by

Type of publication:
Journal article

Author(s):
Mehta N.; Williams R.J.; Smith M.E.; Hall A.; Hardman J.C.; Cheung L.; Ellis M.P.; *Fussey J.M.; Lakhani R.; Hopkins C.; McLaren O.; Nankivell P.C.; Sharma N.; Yeung W.; Carrie S.

Citation:
Journal of Laryngology and Otology; Jun 2017; vol. 131 (no. 6); p. 518-522

Abstract:
Objective: To investigate the feasibility of a national audit of epistaxis management led and delivered by a multiregion trainee collaborative using a web-based interface to capture patient data. Methods: Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was adapted and installed within the infrastructure of a university secure server. Site-lead feedback was assessed through questionnaires. Results: Sixty-three patients with epistaxis were admitted over a two-week period. Site leads reported an average of 5 minutes to complete questionnaires and described the tool as easy to use. Data quality was high, with little missing data. Site-lead feedback showed high satisfaction ratings for the project (mean, 4.83 out of 5). Conclusion: This pilot showed that trainee collaboratives can work together to deliver an audit using an encrypted data capture tool cost-effectively, whilst maintaining the highest levels of data quality.

Torrential epistaxis in the third trimester: a management conundrum. (2014)

Posted on by

Author(s):
Crunkhorn RE, *Mitchell-Innes A, Muzaffar J

Citation:
BMJ Case Reports, 2014, vol./is. 2014/, 1757-790X (2014)

Abstract:
Although epistaxis is common during pregnancy, large volume epistaxis is rare. Many standard epistaxis management options are limited in pregnancy due to absolute or relative contraindications. Ear, nose and throat surgeons need to be aware of what options can be used safely and effectively. We present a case of a 32-year-old woman, 32 weeks pregnant, who was admitted with heavy epistaxis refractive to conservative management. Several potential interventions including bismuth iodoform paraffin paste (BIPP) and Floseal were contraindicated or involved additional risk in pregnancy necessitating unorthodox management. This challenging case highlights suitable alternatives for managing large volume epistaxis during pregnancy, as well as discussing the differential diagnosis and relevant investigations. 2014 BMJ Publishing Group Ltd.

Link to full-text: http://casereports.bmj.com/content/2014/bcr-2014-203892.abstract