Ambulatory epistaxis pathway: the Scottish experience
Jimmy Ng, Kate Hulse, Peter Ross, Fergus Cooper, Morton Draegebo, Niall Woodley, Esmond Carr, Gamellial Aremu, Peter Arupiri, Jamie Cooper, Praveen Kumar Devarajan, Chelsea Chan, Alison Lim, Jia Yin Tan, Amy Campbell, Nils Fritsch, Nicola MacInnes, Mohamed Wafa, Alexander Curran, Sam Arman, Ross Hendry, Anna Loroch, Mohammed Faizan Shah, Catriona Douglas, Kerrie McAllister, Hitesh TailorAbstract
Background
Evidence shows that patients with non-dissolvable intranasal packing can be safely managed without hospital admission. However, admission remains standard practice in most UK centres. This study presents the Scottish experience of an ambulatory pathway for packed epistaxis patients.
Methods
In this Scottish ENT Trainee Research Network project, health boards in Scotland conducted two ‘Plan, Do, Study, Act’ cycles between July 2024 and August 2025, applying exclusion criteria agreed by an expert panel. In cycle two, exclusion criteria were adapted locally.
Results
The pathway had no adverse events in the community. Patients felt safe and satisfied, and none re-presented within 30 days. 6 per cent of patients in the first cycle were ambulated successfully, increasing to 13 per cent in the second cycle.
Conclusion
Our pan-Scotland experience demonstrated the ambulatory epistaxis pathway is safe. Future intentions are to refine and embed the pathway nationally and collate evidence to inform UK guidelines.