title: Prospective audit of a dedicated ear, nose and throat emergency department and 24-year comparison.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide road, Dublin 2, Ireland. woodsrsr@gmail.com.
authors.forename: R S R
authors.initials: RS
authors.lastname: Woods
authors.affiliation: Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide road, Dublin 2, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Keane
authors.affiliation: Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide road, Dublin 2, Ireland.
authors.forename: C V
authors.initials: CV
authors.lastname: Timon
authors.affiliation: Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide road, Dublin 2, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: Hone
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004427:Ear Diseases / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D058005:General Practitioners; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000473:pathology; D010038:Otorhinolaryngologic Diseases / Q000453:epidemiology* / Q000628:therapy; D010614:Pharynx / Q000473:pathology; D011446:Prospective Studies; D012017:Referral and Consultation; D055815:Young Adult
keywords: Ambulatory care; ENT; Emergency department; Emergency service; Medical education; Training
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