SRS211 - Epistaxis and suspension of anticoagulants and antiplatelets: the multidisciplinary consensus guideline

Abstract Background The British Rhinological Society Multidisciplinary Consensus on the Hospital Management of Epistaxis published in 2016 recommends the continuation of anticoagulants and antiplatelets in patients with uncomplicated epistaxis. The aim of this audit is to improve adherence to the current consensus guideline. Methods Patients who were admitted under the ear, nose and throat (ENT) department at the Norfolk and Norwich University Hospital (NNUH) with uncomplicated epistaxis from May to September 2024 (cycle one) and were on anticoagulants or antiplatelets were included in our audit. We calculated how many had their antiplatelets or anticoagulants suspended during their admission. We implemented teaching on the national consensus guideline at the December 2024 ENT departmental induction for new ENT doctors. We then recollected the data from December 2024 to February 2025 (second cycle). Results In the first cycle, 22 patients were identified. Anticoagulants or antiplatelets were suspended in 68% of these patients. In the second cycle, 25 patients were identified, and 44% had their anticoagulants or antiplatelets suspended. There was a decrease in the percentage of patients who had their anticoagulants or antiplatelets suspended between the first and second cycles (P < 0.1), leading to an improvement in the adherence to the national consensus guideline. Conclusions Teaching at the ENT department induction improved adherence to the current guideline recommendations to continue anticoagulation and antiplatelets in patients admitted with epistaxis. We aim to share the guideline with emergency department and medical colleagues, and to continue teaching on these guidelines at departmental induction for new ENT doctors.