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Audit of nasal fracture management in accident and emergency in a district general hospital
Author(s) -
Agrawal Namit,
Brayley Nigel
Publication year - 2007
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2006.00700.x
Subject(s) - audit , medicine , accident and emergency , documentation , medical emergency , clinical audit , general surgery , surgery , management , computer science , economics , programming language
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.