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Management of ENT emergencies during the coronavirus disease 2019 pandemic

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  22 February 2021

J Stansfield ,
S Dobbs ,
R Harrison ,
K Lee ,
S Sharma ,
K Okour ,
S Agrawal  and
M S Miah
J Stansfield*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
S Dobbs
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
R Harrison
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
K Lee
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
S Sharma
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
K Okour
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
S Agrawal
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
M S Miah
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
*
Author for correspondence: Mr Joseph Stansfield, Department of Otorhinolaryngology – Head and Neck Surgery, Fairfield General Hospital, Bury, UK E-mail: [email protected]
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Abstract

Background

Coronavirus disease 2019 imposed dramatic changes on ENT service delivery. Pre-pandemic, such changes would have been considered potentially unsafe. This study outlines the impact of lockdown on the incidence and management of ENT emergencies at a large UK centre.

Methods

After modification of pre-pandemic guidelines, ENT emergency referrals data during the UK lockdown were prospectively captured. A comparative analysis was performed with retrospective data from a corresponding period in 2019.

Results

An overall reduction (p < 0.001) in emergency referrals (n = 119) and admissions (n = 18) occurred during the lockdown period compared to the 2019 period (432 referrals and 290 admissions). Specifically, there were reduced admission rates for epistaxis (p < 0.0001) and tonsillar infection (p < 0.005) in the lockdown period. During lockdown, 90 per cent of patients requiring non-dissolvable nasal packing were managed as out-patients.

Conclusions

Coronavirus disease 2019 compelled modifications to pre-pandemic ENT guidelines. The enforced changes to emergency care appear to be safe and successfully adopted. Arguably, the measures have both economic and patient-related implications post-coronavirus disease 2019 and during future similar pandemics and lockdowns.

Keywords

EpistaxisPeritonsillar AbscessCOVID-19
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 2 , February 2021 , pp. 117 - 124
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Mr J Stansfield takes responsibility for the integrity of the content of the paper

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