Can junior doctors provide immediate help in airway and other ENT emergencies?
Reviewed by Madhup K Chaurasia

In the present trends for centralisation of ENT emergency services, availability of immediate middle grade or senior help in acute ENT emergencies does not always exist on site and hence the role of junior doctors in handling this is enhanced and could be crucial. This is an interesting survey of what junior doctors can do or feel confident to handle in various acute situations. One-hundred-and-four doctors from 48 different hospitals responded to questions on their knowledge of anatomy of the head and neck and their ability to handle common acute situations such as post tonsillectomy bleeding, epistaxis, foreign bodies amongst several other ENT emergencies and most importantly, management of compromised airway. Many did not feel confident in identifying common problems such as peritonsillar abscess (36%), posterior epistaxis (58%), and post tonsillectomy bleeding (66%). Most concerning were the findings regarding management of the airway problem, 14% stating they would not be able to identify stridor! Very few knew to give steroids and nebulised adrenaline and only 49% said they would give oxygen. The understanding of tracheostomy and laryngectomy tubes was found to be very poor as well. Doctors who had gone through advanced resuscitation courses and anaesthetic departments fared relatively better. Therefore, despite centralisation being cost effective, the primary need for mandatory and multidisciplinary teaching of these doctors in ENT and airway emergencies cannot be overlooked. 

ENT and airways in the emergency department: national survey of junior doctors’ knowledge and skills.
Whitcroft KL, Moss B, McRae A.
THE JOURNAL OF LARYNGOLOGY AND OTOLOGY
2016;139:183-9.