| 🩸 Epistaxis |
- Bleeding from one or both nostrils.
- Anterior bleeds more common.
- Posterior bleeds may cause haemodynamic instability.
- May be associated with anticoagulation, trauma or hypertension.
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- Clinical exam with nasal speculum/light.
- FBC, clotting if severe/recurrent.
- Consider group and save if heavy bleed.
- Endoscopy if difficult to localise.
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- Sit forward, pinch soft nose for 10–15 min.
- Topical vasoconstrictor if available.
- Silver nitrate cautery if clear bleeding point.
- Nasal packing if ongoing bleed.
- Urgent ENT for posterior bleed or uncontrolled haemorrhage.
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| 🗣 Peritonsillar Abscess (Quinsy) |
- Severe unilateral sore throat.
- Trismus.
- Muffled “hot potato” voice.
- Uvular deviation.
- Fever and odynophagia.
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- Clinical diagnosis.
- Bloods if septic.
- Imaging only if diagnosis uncertain or deep neck infection suspected.
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- Urgent ENT review.
- Drainage (needle aspiration or incision).
- IV or oral antibiotics depending on severity.
- Analgesia and hydration.
- Airway assessment if severe swelling.
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| 🫁 Acute Epiglottitis / Supraglottitis |
- Rapid sore throat with severe pain.
- Drooling and dysphagia.
- Muffled voice.
- Stridor or respiratory distress.
- Patient may sit forward.
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- Clinical diagnosis.
- Do not distress patient unnecessarily.
- Flexible nasendoscopy only by experienced clinician.
- Bloods/cultures once stable.
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- Airway first.
- Urgent ENT + anaesthetics.
- High-flow oxygen.
- IV antibiotics.
- HDU/ICU monitoring.
- Avoid throat examination with tongue depressor if unstable.
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| 🍇 Airway Foreign Body |
- Sudden choking.
- Cough or inability to speak.
- Stridor or wheeze.
- Possible unilateral reduced breath sounds.
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- Clinical diagnosis.
- CXR if stable.
- Bronchoscopy is definitive.
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- Immediate choking algorithm.
- Call emergency help.
- Rigid bronchoscopy for removal.
- Oxygen and airway support.
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| 👂 Sudden Sensorineural Hearing Loss |
- Sudden unilateral hearing loss.
- Tinnitus.
- Ear fullness.
- ± Vertigo.
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- Tuning fork tests.
- Audiology.
- MRI later to exclude retrocochlear pathology.
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- Urgent ENT referral.
- Prompt steroids depending on timing/local pathway.
- Do not assume wax or otitis media without examination.
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| 🦷 Ludwig’s Angina |
- Submandibular swelling.
- Floor-of-mouth swelling.
- Tongue elevation.
- Drooling and dysphagia.
- Often dental origin.
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- Clinical airway assessment.
- CT neck if stable.
- Blood cultures and inflammatory markers.
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- Airway emergency.
- ENT/maxfax + anaesthetics.
- IV broad-spectrum antibiotics.
- Surgical drainage if collection.
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| 👃 Nasal Fracture + Septal Haematoma |
- Nasal trauma.
- Pain/swelling.
- Epistaxis.
- Septal haematoma = bilateral boggy septal swelling.
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- Clinical diagnosis.
- Assess septum carefully.
- CT only if facial fracture concern.
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- Ice + analgesia.
- ENT review for deformity.
- Drain septal haematoma urgently to prevent necrosis/abscess.
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| 🦴 Acute Mastoiditis |
- Post-auricular pain/swelling.
- Fever.
- Pinna displaced forwards.
- Often recent otitis media.
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- Bloods.
- CT temporal bone if concern for complications.
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- Admit.
- IV antibiotics.
- ENT review.
- Myringotomy or mastoidectomy if needed.
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| 🦠 Necrotising (Malignant) Otitis Externa |
- Severe otalgia.
- Otorrhoea.
- Granulation tissue.
- Usually diabetes or immunocompromise.
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- Swab/culture.
- Inflammatory markers.
- CT/MRI temporal bone.
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- Urgent ENT.
- Antipseudomonal antibiotics.
- Optimise glucose control.
- Monitor cranial nerves.
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| 🧠 Deep Neck Space Infection |
- Neck swelling.
- Severe sore throat.
- Fever.
- Torticollis.
- Voice change.
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- CT neck with contrast.
- Blood cultures.
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- ENT + anaesthetics.
- IV antibiotics.
- Drainage if collection.
- Airway monitoring.
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