Adult

EAR

• Trauma
• Mastoiditis/cholesteatoma, acute and complicated
• ENT conditions with associated neurological signs
• Ear canal oedema/unable to clear discharge
• Vertigo, sudden onset, debilitating, constant (vestibular neuritis/stroke)
• Barotrauma with sudden onset vertigo
• Hearing loss with associated neurological signs
• Sudden / Rapid onset unilateral or bilateral hearing loss (>30dBHL at 3 or more frequencies that developed over less than a 72-hour period)

  (direct phone contact with the ENT registrar on call to discuss the case and arrange review as clinically appropriate)

• Facial weakness, sudden onset
• Foreign body
• Auricular haematoma

NOSE

• Acute bacterial rhinosinusitis - visual disturbance/signs, neurological signs/frontal swelling/severe unilateral or bilateral headache
• Acute nasal fracture with septal haematoma
• Unilateral facial swelling with or without dental sepsis
• Severe or persistent epistaxis

THROAT

• Airway compromise- stridor/drooling breathing difficulty/acute or sudden voice change/severe odynophagia
• Ludwig's angina
• Acute tonsillitis with airway obstruction and/or unable to tolerate oral intake and/or uncontrolled fever
• Tonsillar haemorrhage
• Abscess or haematoma, (e.g. peritonsillar abscess/quinsy, salivary abscess) with or without associated cellulitis
• Acute hoarseness associated with neck trauma or surgery
• Laryngeal obstruction and/or fracture
• Pharyngeal/laryngeal foreign body
• Accidental dislodgement or obstruction of permanent tracheostomy
• New onset of bleeding or shrinkage of laryngectomy stoma
• Profound dysphagia (i.e. inability to manage secretions)
• Supraglottitis

Paediatric

EAR

• Foreign body
• Trauma
• New onset facial nerve palsy
• ENT conditions with associated neurological signs e.g. facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
• Acute and/or complicated mastoiditis
• Otitis externa with uncontrolled pain and/or cellulitis extending beyond the ear canal and/or ear canal is swollen shut
• Auricular haematoma
• Any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis etc

NOSE

• Foreign body (button batteries)
• Trauma with other associated injuries i.e. other facial fractures e.g. orbit
• Periorbital cellulitis with or without swelling with or without sinusitis
• Severe or persistent epistaxis
• Septal haematoma

THROAT

• Foreign body (button batteries – inhaled or ingested). if suspicion of button battery immediate emergency review
• Acutely enlarging neck mass with any associated airway symptoms e.g. stridor, drooling, dysphagia etc
• Airway compromise: severe stridor/drooling/ breathing difficulty/acute, sudden voice change/ severe odynophagia
• Trauma
• Abscess or haematoma (e.g. peritonsillar, parapharyngeal (quinsy), salivary, neck or retropharyngeal abscess)
• Post-tonsillectomy haemorrhage
• Hoarseness associated with neck trauma or surgery
• If new onset hoarse voice and any airway obstructive symptoms  

SLEEP DISORDERED BREATHING/OBSTRUCTIVE SLEEP APNOEA

• Clinical concern regarding prolonged apnoeas, cyanosis, altered level of consciousness or significant and escalating parental concerns should prompt direct phone contact with the ENT registrar on call to discuss the case and arrange review as clinically appropriate