Ear, nose and throat emergencies at the RLI: audit analysis

Abstract

The new purpose-built ENT unit at the Royal Lancaster Infirmary (RLI) was opened in February 1996. It is currently a five-day ward, open from Monday 9am to Friday 5pm. The cover for weekends and bank holidays is provided by the Royal Preston Hospital, twenty miles south of Lancaster. The two consultant ENT surgeons at the RLI share a one in six rota with their colleagues from the Royal Preston Hospital to cover the weekends and bank holidays. The inconvenience caused to patients and their relatives aswell as the disruption of continuity of care is yet to be assessed. The emergency workload of any ENT department is from three sources: in-hospital referrals, referrals from general practitioners and accident & emergency (A&E) departments. The latter account for a large proportion of this emergency workload. The most common diagnoses necessitating referral are foreign bodies in the aerodigestive tract, followed by epistaxis and some form of ear sepsis. Little work has been done, however, with regard to the ENT condition seen in the A&E unit. In our study, we looked at the referrals to the ENT departments at the RLI and the Royal Preston Hospital from the Lancaster A&E department to determine the pattern of patients' referral and their management.