Are nasal fractures being referred appropriately from the accident and emergency department to ENT?

Abstract

Nasal trauma does not always require ENT clinic follow-up. We assess the appropriateness of referral to the ENT department from A&E of suspected nasal fractures. The 342 case notes of patients referred to ENT from A&E with suspected nasal fractures were reviewed. The patients were divided into groups depending on whether or not they showed clinical features in A&E. Patients showing clinical features in A&E initially were significantly [P < .005] more likely to attend their clinic appointment than those without clinical features. They were also significantly more likely [P < 0.001] to undergo surgical correction of their nose. Suspected nasal fractures following trauma should be referred to ENT only if they show clinical features on presentation to A&E. For patients developing clinical features over the next 3 weeks a telephone number should be given to the patient for rapid access to the ENT clinic.