Ambulatory management of common ENT emergencies – what's the evidence?

Heining, Chris; Amlani, Ashraf; Doshi, Jayesh

doi:10.1017/s0022215121000554

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…5 Other studies reported the most common types of inpatient and outpatient otolaryngology consultations during the initial COVID-19 surge, and the methods of management with important safety considerations. 6,7 Despite the flurry of useful information on practice patterns during the first surge of the pandemic, there is no literature to date examining the lasting effect on otolaryngology practice as the healthcare system navigates to a new steady state. Measuring practice patterns is critical to continue to uphold our clinical and academic mission.…”

Section: Smentioning

confidence: 99%

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Inpatient Otolaryngology Consultations and COVID-19: The Surge and Lasting Effects at an Urban, Academic Institution

et al. 2023

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Objective: This study aims to examine the lasting effects of the coronavirus disease 2019 (COVID-19) pandemic on inpatient otolaryngology consultations. Methods: In a retrospective analysis, inpatient otolaryngology consultations at an urban, academic tertiary care center were reviewed over the course of 2 years (Jun 2019-Jun 2021). The consultations were categorized by time period based on the local data for COVID-19 hospitalizations and deaths as follows: pre-COVID (Jun 2019-Feb 2020), Surge 1 (Mar 2020-May 2020), Surge 2 (Oct 2020-Jan 2021), and Post Surge (Mar 2021-Jun 2021). Results: A total of 897 patients undergoing an inpatient otolaryngology consultation across all 4 time periods were included for analysis. The average consultations per day was 1.67 ± 0.24 in pre-COVID times, and dropped acutely to 0.86 ± 0.33 consultations per day during Surge 1. The consultation volume was not statistically different from pre-COVID levels during Surge 2 (1.33 ± 0.35) and Post Surge (1.60 ± 0.20). Reason for consultation and procedures performed did not vary significantly between pre-COVID times and Post Surge, except that consultation for postoperative complaint was less frequent in Post Surge (4.8% vs 1.0%, P = .02). More patients had been screened with rapid antigen COVID testing in Post Surge versus Surge 1 (20.1% vs 7.6%, P = .04). Conclusions: Inpatient otolaryngology consultation volumes, indications, and procedures performed at an urban, academic institution returned to pre-COVID levels after being significantly impacted during Surge 1.

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Section: Smentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inpatient Otolaryngology Consultations and COVID-19: The Surge and Lasting Effects at an Urban, Academic Institution

et al. 2023

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“…[7][8][9] Building on this, some have proposed standardized clinical care pathways for managing epistaxis while minimizing transfers, admissions, and ENT consults. [10][11][12] However, no studies yet have characterized the details of ENT consults for epistaxis in the ED. Thus, this study aims to analyze ED utilization and management for patients with epistaxis.…”

Section: Introductionmentioning

confidence: 99%

Treatment, Management, and Otolaryngology Consultation for Epistaxis in the Emergency Room: An Institutional Experience

Jacobs,

Wang,

Chao

et al. 2023

Am J Rhinol�Allergy

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Background Epistaxis is a common reason for emergency department (ED) visits, accounting for approximately 1 of every 200 ED visits in the United States annually and up to one-third of all otolaryngology (ENT)-related ED encounters. Objectives To detail reasons for ENT consultation for epistaxis in the ED, understand how consultation impacts patient care, assess follow-up patterns after emergency care, and study patient care after transfer or referral into the ED. Methods Retrospective chart review of 592 adult patients with epistaxis managed in a tertiary care ED setting between 2017 and 2018. Patients with known follow-up, ENT consult in the ED, or admission were included, while patients with trauma, recent head and neck surgery, or abnormal anatomy were excluded. Results The most common reasons for ENT consultation for epistaxis were for advanced management, referral to the ED from an outside facility or provider, and recent head and neck surgery. In total, 48.2% of patients treated for epistaxis in the ED received an ENT consultation. ENT consultation was associated with a higher likelihood of receiving absorbable or nonabsorbable packing (92.4% vs 36.1%). In total, 40.4% of patients referred into the ED from an outside facility or provider had no change in their management after receiving an ENT consult. Patients referred to the ED and White patients were significantly more likely to receive an ENT consult. Secondary analyses revealed that more White patients had an established outpatient ENT provider than patients of other races. On multivariate analysis, patients who received an ENT consult spent 75.2 min longer in the ED. Conclusion The high percentage of patients referred or transferred to the ED for epistaxis management with no change in interventions after ENT consultation indicates a continued need to develop more precise clinical care pathways. Additionally, there may be gaps between White and non-White patients in access to ENT care.

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Evaluating a specialized workshop on otorhinolaryngology emergencies for junior doctors: Empowering the next generation of healers

Giri,

Khan,

Parajuli

et al. 2024

Medicine

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Otorhinolaryngology (ORL) emergencies, including airway obstructions, epistaxis, and foreign body removal, require prompt and specialized medical intervention. Junior doctors, particularly those in the early stages of their careers, often face challenges in managing these conditions due to limited exposure to ORL-specific training during their internships. While general medical education provides foundational skills, it may not sufficiently prepare junior doctors to handle the complexities of ORL emergencies. As junior doctors are often the first point of contact for urgent ORL cases in emergency departments, targeted training is critical to enhance their competence and improve patient outcomes. This study assessed the effectiveness of a specialized workshop focused on ORL emergencies, attended by 41 junior doctors. The cohort had varying levels of clinical experience, with 31 having completed 6 months and 10 having completed 12 months of internship. Of the participants, 25 had prior exposure to ORL during their internship rotations, while 16 had not. The cohort had a mean age of 24.73 years (SD = ±1.30), with a gender distribution of 21 females and 20 males. None of the participants had previously attended formal training specifically focused on ORL emergencies. Knowledge improvement was measured using pre- and posttest scores, with statistical analysis to assess the significance of the change. The mean pretest score was 9.95 (SD = 2.97), and the mean posttest score was 12.78 (SD = 2.73). The improvement in scores was statistically significant (P < .0001), indicating that the workshop was effective in enhancing participants’ knowledge of ORL emergencies. The workshop significantly improved junior doctors’ knowledge of ORL emergencies, addressing important gaps in their training. By providing specialized education to a diverse group of early-career doctors, the initiative enhanced their preparedness to manage urgent ORL conditions, ultimately contributing to better patient care and safety in emergency settings.

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Ambulatory management of common ENT emergencies – what's the evidence?

Cited by 4 publications

References 24 publications

Inpatient Otolaryngology Consultations and COVID-19: The Surge and Lasting Effects at an Urban, Academic Institution

Inpatient Otolaryngology Consultations and COVID-19: The Surge and Lasting Effects at an Urban, Academic Institution

Treatment, Management, and Otolaryngology Consultation for Epistaxis in the Emergency Room: An Institutional Experience

Evaluating a specialized workshop on otorhinolaryngology emergencies for junior doctors: Empowering the next generation of healers

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