Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T09:47:27.332Z Has data issue: false hasContentIssue false
  • English
  • Français

ENT UK coronavirus disease 2019 adult tonsillitis and quinsy guidelines: translating guidance into practice

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  03 March 2021

M J Edwards ,
T W James  and
C L Dalton
M J Edwards*
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
T W James
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
C L Dalton
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
*
Author for correspondence: Dr Michael J Edwards, Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK E-mail: michael.edwards19@nhs.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

This study examined the uptake of ENT UK coronavirus disease 2019 adult tonsillitis and quinsy guidelines at our tertiary centre, and assessed perceived barriers to uptake.

Methods

A retrospective case series of tonsillitis and quinsy patients was analysed in two arms: before and after the introduction of new ENT UK management guidelines. A survey assessed perceptions and practice differences between ENT and emergency department doctors.

Results

Each study arm examined 82 patients. Following the introduction of new ENT UK guidelines, ENT clinicians demonstrated significant changes in practice, unlike their emergency department counterparts. Survey results from emergency department doctors highlighted a lack of appreciation of guideline change and identified barriers to guideline uptake.

Conclusion

The introduction of new management guidelines for tonsillitis and quinsy patients during the pandemic resulted in disparate uptake within ENT and emergency department departments at the tertiary centre. Clearer dissemination to all affected clinicians is paramount for future rapidly introduced changes to practice, to ensure clinician safety.

Keywords

COVID-19TonsillitisPeritonsillar AbscessGuideline AdherencePovidone-Iodine
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 7 , July 2021 , pp. 579 - 583
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr M J Edwards takes responsibility for the integrity of the content of the paper

References

Georgalas, CC, Tolley, NS, Narula, PA. Tonsillitis. BMJ Clin Evid 2014;2014:0503Google ScholarPubMed
Powell, EL, Powell, J, Samuel, JR, Wilson, JA. A review of the pathogenesis of adult peritonsillar abscess: time for a re-evaluation. J Antimicrob Chemother 2013;68:1941–50CrossRefGoogle ScholarPubMed
Scottish Intercollegiate Guidelines Network. Management of Sore Throat and Indications for Tonsillectomy: A National Clinical Guideline. Edinburgh: Scottish Intercollegiate Guidelines Network, 2010Google Scholar
Bird, JH, Biggs, TC, Schulz, C, Lower, N, Faris, C, Repanos, C. Implementation of an evidence-based acute tonsillitis protocol: our experience in one hundred and twenty-six patients. Clin Otolaryngol 2013;38:410–15CrossRefGoogle ScholarPubMed
Al-Jabir, A, Kerwan, A, Nicola, M, Alsafi, Z, Khan, M, Sohrabi, C et al. Impact of the coronavirus (COVID-19) pandemic on surgical practice - Part 1. Int J Surg 2020;79:168–79CrossRefGoogle ScholarPubMed
Givi, B, Schiff, BA, Chinn, SB, Clayburgh, D, Iyer, NG, Jalisi, S et al. Safety recommendations for evaluation and surgery of the head and neck during the COVID-19 pandemic. JAMA Otolaryngol Head Neck Surg 2020;146:579–84CrossRefGoogle ScholarPubMed
Aerosol-generating procedures in ENT. In: https://www.entuk.org/aerosol-generating-procedures-ent [12 December 2020]Google Scholar
ENT UK COVID-19 Adult Tonsillitis & Quinsy Guidelines. In: https://www.entuk.org/sites/default/files/ENT%20UK%20COVID-19%20Tonsillitis%20%26%20Quinsy%20Guidelines%20FINAL.pdf [12 December 2020]Google Scholar
A&E Attendances and Emergency Admissions March 2020 Statistical Commentary. In: https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2020/04/Statistical-commentary-March-2020-jf8hj.pdf [12 December 2020]Google Scholar
Royal College of General Practitioners. RSC Communicable and Respiratory Disease Report for England: week number/year 29/2020. In: https://www.rcgp.org.uk/-/media/Files/CIRC/WeeklyReport_Summer_wk29_2020 [12 December 2020]Google Scholar
Islam, N, Sharp, SJ, Chowell, G, Shabnam, S, Kawachi, I, Lacey, B et al. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries. BMJ 2020;370:m2743CrossRefGoogle ScholarPubMed
Miles, DK, Stedman, M, Heald, AH. “Stay at home, protect the national health service, save lives”: a cost benefit analysis of the lockdown in the United Kingdom. Int J Clin Pract 2021;75:e13674CrossRefGoogle ScholarPubMed
Angoulvant, F, Ouldali, N, Yang, DD, Filser, M, Gajdos, V, Rybak, A et al. Coronavirus disease 2019 pandemic: impact caused by school closure and national lockdown on pediatric visits and admissions for viral and nonviral infections—a time series analysis. Clin Infect Dis 2021;72:319–22CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Sore throat – acute. Scenario: Management. In: https://cks.nice.org.uk/topics/sore-throat-acute/management/management/ [12 December 2020]Google Scholar
Centor, RM, Witherspoon, JM, Dalton, HP, Brody, CE, Link, K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making 1981;1:239–46CrossRefGoogle Scholar
Little, P, Stuart, B, Hobbs, FDR, Butler, CC, Hay, AD, Campbell, J et al. Predictors of suppurative complications for acute sore throat in primary care: prospective clinical cohort study. BMJ 2013;347:f6867CrossRefGoogle ScholarPubMed
Reimer, K, Wichelhaus, TA, Schäfer, V, Rudolph, P, Kramer, A, Wutzler, P et al. Antimicrobial effectiveness of povidone-iodine and consequences for new application areas. Dermatology 2002;204(suppl 1):114–20CrossRefGoogle ScholarPubMed
Anderson, DE, Sivalingam, V, Kang, AEZ, Ananthanarayanan, A, Arumugam, H, Jenkins, TM et al. Povidone-iodine demonstrates rapid in vitro virucidal activity against SARS-CoV-2, the virus causing COVID-19 disease. Infect Dis Ther 2020;9:669–75CrossRefGoogle ScholarPubMed
Kirk-Bayley, J, Challacombe, S, Sunkaraneni, V, Combes, J. The use of povidone iodine nasal spray and mouthwash during the current COVID-19 pandemic may protect healthcare workers and reduce cross infection. SSRN Electronic Journal 2020 doi:10.2139/ssrn.3563092CrossRefGoogle Scholar
Runnacles, J, Roueché, A, Lachman, P. The right care, every time: improving adherence to evidence-based guidelines. Arch Dis Child Educ Pract Ed 2018;103:27–33CrossRefGoogle ScholarPubMed