Improving the management of suspected tonsillitis and peritonsillar abscess referred to ENT - a coronavirus disease 2019 service improvement

BACKGROUND: The impact of coronavirus disease 2019 on healthcare has led to rapid changes in otolaryngology service provisions. As such, new standard operating procedures for the management of suspected tonsillitis or quinsy were implemented in our centre.

METHODS: A retrospective audit was performed of acute referrals to ENT of patients with suspected tonsillitis, peritonsillar cellulitis or quinsy, during the 10 weeks before (group 1) and 10 weeks after (group 2) implementation of the new standard operating procedures.

RESULTS: Group 2 received fewer referrals. Fewer nasendoscopies were performed and corticosteroid use was reduced. The frequency of quinsy drainage performed under local anaesthetic increased, although the difference was not statistically significant. Hospital admission rates decreased from 56.1 to 20.4 per cent, and mean length of stay increased from 1.13 to 1.5 days. Face-to-face follow up decreased from 15.0 to 8.2 per cent, whilst virtual follow up increased from 4.7 to 16.3 per cent. There were no significant differences in re-presentation or re-admission rates.

CONCLUSION: Management of suspected tonsillitis or quinsy using the new standard operating procedures appears to be safe and effective. This management should now be applied to an out-patient setting in otherwise systemically well patients.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

The Journal of laryngology and otology - Vol. 135, No. 7 (2021), p. 584-588

Language:

English

Contributors:

Cereceda-Monteoliva, N
Devabalan, Y
Lorenz, H
Magill, J C
Unadkat, S
Rennie, C

Urls:

Volltext

Keywords:

*Quality Improvement
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy, Fine-Needle
COVID-19
Coronavirus
Drainage
Female
Hospitalization
Humans
Journal Article
Length of Stay
London
Male
Middle Aged
Otolaryngology
Pandemics
Peritonsillar Abscess
Practice Patterns, Physicians'
Quality Improvement
Referral and Consultation
Retrospective Studies
Tonsillitis
Young Adult

Notes:

Date Completed 16.07.2021

Date Revised 16.07.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1017/S0022215121001213

PMID:

33913412

PPN (Catalogue-ID):

NLM325777977