ENT Emergencies

Martin Porter
Consultant ENT
Worcester
 ENT Emergencies
 90% staightforward and easy to treat
 10% serious and potential for disaster
Common ENT emergencies
 Epistaxis
 Sore throats
 Foreign body
 Fractured nose
 Ear infection
 Rare but dangerous
 Secondary haemorrhage
 Airway obstruction
 Sepsis
 Epistaxis
Young Elderly
 Usually mild  Can be severe
 Usually venous  Can be arterial
 Anterior septal  Can be posterior
 Cautery usually side wall
possible  Packing often
necessary
 Epistaxis-Causes
 Idiopathic
 Trauma
 Warfarin
 (Haematological)

 NOT BP!
 Epistaxis- you need
 Protection
 Illumination
 Suction
 Analgesia/anaesthesia
 Cautery/packing
 Sore Throat
 Viral pharyngitis/laryngitis
 Glandular fever
 Acute bacterial tonsillitis
– Quinsy
– Parapharyngeal abscess
 Sore throat-treatment
 Analgesics
 Rehydrate
 Antibiotics
 Admit
– Unable to swallow
– Airway obstruction
– abscess
 Foreign Body
 Ear/Nose
– child
– hook
 Throat
– bolus
– fish bone
 Bronchus
Diagnosis-Signs
Ear infections – Otitis media
 Children
 History of URTI/Glue ear
 Pain (then burst)
 Mucous discharge
 Treatment
– Symptomatic
– Systemic antibiotics
Ear infections- Otitis externa
 All ages, usually adult
 History of itch/swimming/scratch
 Painful
 Thin discharge
 Narrow ear canal
 Treatment
– topical drops
– wick
– toilet
 Airway obstruction
Adult Child
 Trauma  Epiglotitis
 Tumour  LTB
 Inflammation  Foreign body
 Airway obstruction
 Get help!
– Anaesthatist
– Paediatrician
– ENT (endoscopy)
 Give O2 / heliox
 IVI
– Steroids
– Antibiotics
– Adrenaline
 Secondary Haemorrhage
 Tonsils 5-10 days post op.
 Examine mouth
 Call for help
– Anaesthatist
– ENT
– Paeds
 IVI
 Ressuscitate
 Fractured nose
 Reduce immediately or 5-20 days later
 Refer Wednesday PM clinic
 Septal haematoma
– child
– blocked nose
– headache
FY Teaching programme
ENT
Martin Porter
Consultant
 ENT Emergencies
 Audiograms
 Ears
 Q and A