Management of patients with epistaxis by general practitioners: impact of otolaryngology experience on their practice

This study aims to assess the management of patients with epistaxis by general practitioners (GPs) and to show whether previous experience as a junior doctor in ear, nose and throat (ENT) surgery influences their practice. A questionnaire was sent together with self-addressed reply envelopes to a random sample of 1,000 GPs. Four hundred and twenty eight GPs replied (43% response rate). Ninety-eight percent GPs see less than five epistaxis per week. Eighty-six percent GPs seek a specialist opinion for approximately one in four patients seen. Fifty percent GPs would arrange investigations. There was a wide variation in these and the first aid advice given. Fifteen percent GPs had previous experience in ENT. The only significant difference in the management of epistaxis with these GPs is that they were 2x more likely to cauterize a nose with silver nitrate (P=0.002). There is no general consensus on the management of epistaxis by GPs and despite previous experiences in the specialty as a junior doctor, this fails to have a significant impact on the day to day management of epistaxis.