Current understanding of epistaxis management amongst junior doctors: a cross-sectional study

Background: Epistaxis is a common Ear, Nose and Throat (ENT) presentation to the emergency department and primary care settings. This survey study assesses the current understanding of epistaxis management amongst junior doctors. Methods: A cross-sectional study was conducted for junior doctors across New South Wales and Australia Capital Territory public hospitals. The survey assessed basic understanding and management principles of epistaxis. Results: A total of 105 junior doctors responded. More than half the respondents would incorrectly place pressure on the nasal bones during epistaxis and two-thirds had no confidence in silver nitrate cautery. Three-quarters of the cohort had less than 1 week of ENT exposure during medical school. Junior doctors with more than 1 week of ENT exposure during medical school had higher confidence with silver nitrate cautery (P=0.001) and were six-times more likely to correctly apply pressure to the nasal alae during epistaxis (P<0.001). Junior doctors with any post-graduate ENT experience were three times more likely to correctly identify a type of nasal packing used in epistaxis management (P=0.043). Conclusions: Given the challenges in ensuring adequate ENT exposure during medical school, efforts should be made to ensure all junior doctors feel confident with basic management of epistaxis and meet minimum safe competence.