About emergncy in ent department

1. ENT Emergencies
Martin Porter
Consultant ENT
Worcester

2. ENT Emergencies
 90% staightforward and easy to treat
 10% serious and potential for disaster

3. Common ENT emergencies
 Epistaxis
 Sore throats
 Foreign body
 Fractured nose
 Ear infection

4. Rare but dangerous
 Secondary haemorrhage
 Airway obstruction
 Sepsis

5. Epistaxis
Young
 Usually mild
 Usually venous
 Anterior septal
 Cautery usually
possible
Elderly
 Can be severe
 Can be arterial
 Can be posterior
side wall
 Packing often
necessary

8. Epistaxis-Causes
 Idiopathic
 Trauma
 Warfarin
 (Haematological)
 NOT BP!

9. Epistaxis- you need
 Protection
 Illumination
 Suction
 Analgesia/anaesthesia
 Cautery/packing

17. Sore Throat
 Viral pharyngitis/laryngitis
 Glandular fever
 Acute bacterial tonsillitis
– Quinsy
– Parapharyngeal abscess

18. Sore throat-treatment
 Analgesics
 Rehydrate
 Antibiotics
 Admit
– Unable to swallow
– Airway obstruction
– abscess

19. Foreign Body
 Ear/Nose
– child
– hook
 Throat
– bolus
– fish bone
 Bronchus

20. Diagnosis-Signs

21. Ear infections – Otitis media
 Children
 History of URTI/Glue ear
 Pain (then burst)
 Mucous discharge
 Treatment
– Symptomatic
– Systemic antibiotics

22. Ear infections- Otitis externa
 All ages, usually adult
 History of itch/swimming/scratch
 Painful
 Thin discharge
 Narrow ear canal
 Treatment
– topical drops
– wick
– toilet

23. Airway obstruction
Adult
 Trauma
 Tumour
 Inflammation
Child
 Epiglotitis
 LTB
 Foreign body

24. Airway obstruction
 Get help!
– Anaesthatist
– Paediatrician
– ENT (endoscopy)
 Give O2 / heliox
 IVI
– Steroids
– Antibiotics
– Adrenaline

25. Secondary Haemorrhage
 Tonsils 5-10 days post op.
 Examine mouth
 Call for help
– Anaesthatist
– ENT
– Paeds
 IVI
 Ressuscitate

26. Fractured nose
 Reduce immediately or 5-20 days later
 Refer Wednesday PM clinic
 Septal haematoma
– child
– blocked nose
– headache

27. FY Teaching programme
ENT
Martin Porter
Consultant

28.  ENT Emergencies
 Audiograms
 Ears
 Q and A