Introduction We aimed to improve the management of epistaxis at St Mary’s ED. Our intervention was targeted teaching to St Mary’s ED SHOs. We assessed concordance with ENT UK guidelines and clinician confidence pre-and post-intervention.

Methods For this cycle, we used the QLIK Sense Database to search ED Encounters July-September 2023 for discharges marked ‘epistaxis’ or ‘bleeding from nose’. Data was gathered to assess whether history and examination was documented according to ENT UK epistaxis guidelines. We subsequently delivered teaching to 9 SHOs emphasising the guidelines. Clinician confidence was assessed using surveys, and we repeated data collection for a one-month period following the teaching session.

Results Pre-intervention data was collected from 20 patients; 75% had documented history and examination of the nose as per the guidelines. This improved to 90% for examination and 100% for history from a post-intervention data set of 10 patients. Before the intervention, 44% of clinicians felt extremely or very confident managing acute epistaxis, which improved to 78% post-intervention. There was a paucity of standardised documentation, and to address this we have created a Cerner autotext for the next cycle.

Conclusion Our teaching session increased documentation of epistaxis history and examination as per ENT UK guidelines. It also improved clinician confidence in managing epistaxis. An autotext is being implemented into Cerner for the second cycle.