Prospective audit of a dedicated ear, nose and throat emergency department and 24-year comparison

Ir J Med Sci. 2017 Feb;186(1):247-254. doi: 10.1007/s11845-016-1409-7. Epub 2016 Jan 29.

Abstract

Background: The Royal Victoria Eye and Ear Hospital provides a specialised ear, nose and throat (ENT) Emergency department (ED) service open to patients from the entire country, operating from 9 am to 5 pm on weekdays. Recently, this has been under threat of closure.

Aims: We analyse and determine the role of this ED in the current context and compare results to a previous study from June 1990.

Methods: A prospective study over a 1-month period (March 2014) was conducted. A questionnaire was used, adapted from the study in 1990.

Results: Comparative figures from June 1990 are in parentheses. During the study period, there were 945 (1167) consultations from 887 (779) patients. 57 % (45 %) were new patients and 43 % (55 %) were return patients. Repeat attendances were necessary in 54 (325) patients during this month. 56 % (35 %) were referred by their General Practitioner (GP), 38 % (52 %) self-referred, 2 % (8 %) by other hospitals and 4 % (5 %) from other sources. Diagnoses included otitis externa in 24 % (21 %), cerumen in 20 % (15 %), epistaxis in 6 % (9 %), Eustachian tube dysfunction in 12 %, foreign body removal in 4 % (5 %) and four new cases of head and neck cancer. Attendance numbers vary during the year but demand has risen over time.

Conclusions: A dedicated ED provides an important role for ENT in Ireland and offers valuable experience for trainees. The loss of such a department may lead to an overwhelming burden on services in other hospitals.

Keywords: Ambulatory care; ENT; Emergency department; Emergency service; Medical education; Training.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Ear Diseases / therapy
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • General Practitioners
  • Hospitals*
  • Humans
  • Infant
  • Infant, Newborn
  • Ireland
  • Male
  • Middle Aged
  • Nose / pathology
  • Otorhinolaryngologic Diseases / epidemiology*
  • Otorhinolaryngologic Diseases / therapy
  • Pharynx / pathology
  • Prospective Studies
  • Referral and Consultation
  • Young Adult