Management of ENT emergencies during the coronavirus disease 2019 pandemic

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. After modification of pre-pandemic...

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Bibliographic Details
Published in:Journal of laryngology and otology 2021-02, Vol.135 (2), p.117-124
Main Authors: Stansfield, J, Dobbs, S, Harrison, R, Lee, K, Sharma, S, Okour, K, Agrawal, S, Miah, M S
Format: Article
Language:English
Subjects:
Abscesses
Adolescent
Adult
Aged
Aged, 80 and over
Ambulatory Care - statistics & numerical data
Audit departments
Cellulitis
Comparative analysis
Coronaviridae
Coronaviruses
COVID-19
Disease transmission
Ear
Ear Diseases - epidemiology
Ear Diseases - therapy
Emergencies
Emergency medical care
Emergency Service, Hospital
Epistaxis
Epistaxis - epidemiology
Epistaxis - therapy
Female
Foreign Bodies - epidemiology
Foreign Bodies - therapy
Hospitalization - statistics & numerical data
Hospitals
Humans
Infections
Main
Main Articles
Male
Medical referrals
Middle Aged
Otorhinolaryngologic Diseases - epidemiology
Otorhinolaryngologic Diseases - therapy
Pandemics
Patients
Peritonsillar Abscess - epidemiology
Peritonsillar Abscess - therapy
Physicians
Postoperative Complications - epidemiology
Postoperative Complications - therapy
Practice Guidelines as Topic
Referral and Consultation - trends
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Software
Tonsil
Tonsillitis - epidemiology
Tonsillitis - therapy
Trauma
United Kingdom - epidemiology
Young Adult
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Description
Summary: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. 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. 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. 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.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215121000530