ENT in the Emergency Department

Why This Study Day Matters to Your Career

ENT complaints are one of the more common presentations to ED, especially with children; they will fill a significant number of hours of your time in minors. Despite that frequency, there is often limited exposure to ENT during undergraduate training, thereby establishing what many clinicians refer to as the "fear factor" once these presentations are encountered. The predictable consequences include uncertainty over where the dividing line lies between the routine and the true emergency, with attendant anxiety about missing important diagnoses and a lack of confidence in undertaking practical ENT procedures.

The trick is to sort out from among the myriad of routine ENT complaints those patients who require urgent assessment and treatment. More critically, there are true ENT emergencies that you absolutely must recognize — epiglottitis, severe epistaxis, Ludwig's angina, acute airway obstruction, and penetrating neck trauma — where delayed recognition can be catastrophic. ENT forms a significant part of the clinical practice of emergency medicine clinicians, GPs, and paediatricians, and competence in this area is thus vital for career progression across multiple specialties.

British Medical Courses has created something fundamentally different from traditional ENT training. Our study day is developed by an ED Consultant with a special interest in acute ENT-related problems, with vast experience in managing these conditions in the emergency department. This isn't specialty ENT taught by surgeons in operating theatres — this is practical emergency ENT from someone who navigates these presentations daily in the same pressured environment you work in.

You'll approach various real-life ENT scenarios with a whole different perspective and demystify these common yet anxiety-provoking presentations. We believe in one-to-one learning with custom-tailored plans that address your particular knowledge gaps and uncertainties about procedures. Mastering this key skill will go toward your medical career and make you an expert in dealing with ENT in ED, tackling these presentations with confidence rather than apprehension. We teach you what other courses can't: the systematic approach, practical procedures, and clinical judgment that transforms ENT from a feared specialty into a manageable and satisfying aspect of emergency practice.

Who Will Benefit from This Study Day

This study day is essential for emergency medicine clinicians who want to replace ENT anxiety with competence across the spectrum from routine complaints to life-threatening emergencies. You will benefit greatly if you are an ED doctor who feels underprepared when assessing ENT presentations, or if you do not feel confident in distinguishing serious pathology from benign conditions.

This course will be particularly useful to the emergency medicine trainee in building generic skills, which will help develop systematic approaches to what can be a diagnostically confusing presentation. Indeed, junior doctors often report particular uncertainty when rotating through emergency departments with ENT complaints, especially in pediatric patients where examination can be challenging and serious pathology develops rapidly.

General practitioners working either in emergency departments, urgent care, or primary care encounter ENT complaints constantly. This study day provides the knowledge to manage appropriately in your setting versus when urgent ENT referral is required. Paediatricians and those working in pediatric emergency medicine will particularly benefit given the high prevalence of ENT presentations in children.

The course will be of considerable value to advanced clinical practitioners, emergency nurses working in minors or triage, and urgent care practitioners in understanding when ENT presentations constitute true emergencies. If you've ever felt uncertain how to manage epistaxis, worried about missing a peritonsillar abscess, or unsure when a sore throat might represent something more sinister, this course provides the clarity you need.

Practical and procedure-orientated, this will be of particular value to the experienced clinician who recognises that the limited ENT exposure at undergraduate level has left important gaps in their emergency practice.

What Knowledge and Skills You Will Gain

This focused study day provides emergency clinicians with the essential knowledge and hands-on experience needed to assess and manage both life-threatening and routine ENT presentations with confidence. You will learn to identify true ENT emergencies, manage common conditions effectively, and develop practical procedural skills relevant to emergency medicine practice.

True ENT Emergencies

The course starts with airway emergencies, the most crucial aspect of ENT in the ED. The course will help a learner to evaluate and provide care for acute airway obstruction, identify epiglottitis, peritonsillar abscess, Ludwig's angina, angioedema, and foreign body aspiration. Early recognition, positioning, oxygenation, and escalation of care will be stressed, including when emergency airway intervention is indicated.

Epiglottitis will be discussed in detail, highlighting safe assessment, avoidance of unnecessary distress, and appropriate escalation for airway protection under anaesthetic supervision.

Management of epistaxis will include first-line treatments: compression, ice, and vasoconstrictors; anterior nasal packing; indications for posterior packing, interventional radiology, and surgery. You will also discuss underlying contributing factors such as anticoagulation and hypertension.

Topics to be discussed include Ludwig's angina and deep neck infections, specifically retropharyngeal and parapharyngeal abscesses, focusing on early diagnosis, imaging, airway management, and urgent ENT or maxillofacial involvement.

You will also learn to evaluate penetrating neck trauma with the use of anatomical zones of injury, determine the necessity for operative exploration, and communicate with trauma and vascular teams. Nasal septal haematoma — the commonly missed emergency — will also be discussed regarding its urgent need for drainage and onward referral.

Common ENT Presentations

The course covers the most common ENT cases encountered in the ED beyond emergencies. You'll learn to differentiate and manage otitis externa vs. otitis media, understand malignant otitis externa, and use appropriate topical or systemic therapies.

Tonsillitis and pharyngitis: Centor criteria for practical use, indications of antibiotic use, and complications such as quinsy are also discussed. In the management of sinusitis, red flags of orbital or intracranial complications will be discussed, including rational use of antibiotics.

The course also covers dizziness and vertigo, teaching differentiation of peripheral (BPPV, Ménière's, vestibular neuritis) versus central causes, and the HINTS exam to detect posterior circulation stroke.

Foreign Bodies and Procedures

You will become more confident in managing aural, nasal, and pharyngeal foreign bodies, including understanding when ED removal is appropriate and when ENT referral is safer. Practical workshops will include nasal packing, ear syringing, and microsuction, including use of headlight and otoscope for effective examination.

Medications and Clinical Judgment

Training will also involve the rational use of ENT-specific medications, including topical ear drops, nasal decongestants, steroids, and antibiotics in line with local guidelines. You'll learn when imaging is useful and when urgent versus routine referral is appropriate.

By the end of this study day, you will have a structured, confident approach to ENT cases in the emergency setting. Completion includes a mock exam and certificate of achievement, validating your competence in this essential area of emergency medicine.