학술논문

Audit of nasal fracture management in accident and emergency in a district general hospital.
Document Type
Article
Source
Journal of Evaluation in Clinical Practice. Apr2007, Vol. 13 Issue 2, p295-297. 3p. 3 Graphs.
Subject
*EMERGENCY management
*BONE fractures
*NASAL bone
*MEDICAL audit
*X-rays
*ACCIDENTS
*HOSPITAL care
Language
ISSN
1356-1294
Abstract
Rationale Nasal fractures are a common occurrence in accident and emergency and dealt with by inexperienced senior house officers. This can lead to inappropriate X-rays being performed, no proper documentation of septal haematomas and often no follow-up with a specialist team leading to in some cases complex cosmetic surgery whereas simple manipulation may have sufficed. Method We report an ambispective audit carried out on nasal fracture management in a busy district general hospital over a 6-month period. Results 46 patients were seen 24 in the first 3 months and 22 the next three. 10 had nasal X-ray performed initially on audit. Nine had no documentation of septal haematoma and seven had no follow-up arranged. After appropriate education and the setting up of a department protocol based on best practice, the next cycle was repeated. Two nasal X-rays were performed looking for foreign bodies, all patients had appropriate documentation of septal haematoma and appropriate follow-up. Conclusion Appropriate education and implementation of departmental guidelines can result in more effective and efficient use of resources when dealing with nasal fractures in accident and emergency. [ABSTRACT FROM AUTHOR]