Guidance and FAQs for ENT patients during Covid-19 pandemic - click to read

National recommendations about ear, nose and throat (ENT) services for children have been made to ensure that the risk of spread of the life-threatening new coronavirus causing COVID-19 infection is minimised among patients, families and staff.

We aim to ensure that ear, nose and throat emergencies in children are managed with appropriate urgency whilst minimising the need for hospital admission and risk of harm. Fortunately, the majority of ear, nose and throat conditions in children are not urgent and will not result in serious harm or life-threatening consequences if their management is delayed for a number of months.

General questions:

Q: My child has symptoms of COVID-19 (a high temperature or a continuous cough) and they are due to attend for an ear, nose and throat appointment or operation. What should we do?

A: Do not attend the hospital as planned. For a clinic appointment contact the ear, nose and throat department at the hospital by telephone or email to tell them (phone 0121 333 8111 / e-mail bwc.entbwch@nhs.net) . For an operation, please contact the preadmission service (phone 0121 333 9543).

Current government advice says that your child must stay at home for 7 days and the other members of the household should stay at home for 14 days from the day the first person got the symptoms. For full and up-to-date advice, see https://www.gov.uk/coronavirus.

Q: My child is meant to have an ENT operation. Will they still be able to have it?           

A: Unfortunately, it is not likely to go ahead at the present time. Most, if not all, planned operations have stopped for the time being. Unless he or she is due to have an emergency, urgent or cancer-related operation, it is very likely that the operation will be postponed to a later date.

Q: My child is meant to have an ENT outpatient clinic appointment. Will this still go ahead?           

A: Unfortunately, if it is not an urgent appointment, it is not likely to go ahead at the present time. You may still be contacted by phone to have a virtual or phone consultation. If your appointment is cancelled, it will be rebooked for a later date.

Q: I am concerned that my child’s ear, nose and throat problem has worsened. What should I do? A: If you are under the care of the ear, nose and throat department, please contact them by telephone or e-mail (phone 0121 333 8111 / e-mail bwc.entbwch@nhs.net). If you have not seen an ear, nose and throat service for the problem, please contact your GP.

Q: I am concerned that my child has an ear, nose or throat life-threatening emergency. What should I do?

A: If you think your child has an ear, nose and throat emergency such as uncontrolled severe bleeding or severely blocked breathing, please consider attending Accident and Emergency or calling 999 immediately.

Specific questions:

https://www.nhs.uk/conditions/ has really useful information on many ear, nose and throat topics, including what steps can be taken to manage them at home.

Examples:       

  • broken nose                                 
  • earache
  • ear infections
  • burst eardrum
  • glue ear
  • nosebleed
  • sore throat
  • swollen glands
  • tongue tie
  • tonsillitis

Q: My child normally takes a nasal steroid spray. Should they continue taking it?     

A: Yes, they can. There might be evidence that steroids taken by mouth can make the severity of COVID-19 infections worse, however the current advice is not to stop nasal steroid sprays or steroid asthma inhalers.

Q: My child has a sore throat / an earache / a fever. Should I give them ibuprofen?            

A: There have been concerns circulating in social media and reported in the press about the safety of anti-inflammatory medicines such as ibuprofen in patients with COVID-19.

At present there is no substantial scientific evidence to support this, however we recommend you first give paracetamol, if needed (unless your doctor has told you that paracetamol if not suitable for your child). Follow the manufacturer’s instructions for the appropriate dose for your child’s age. If you continue to be worried about your child’s health, consider seeking advice through NHS 111.

Q: My child has lost their sense of smell but is otherwise fine. Do they have COVID-19 and should we self-isolate as a household                                                                                      

A: It is possible that a new loss of sense of smell (anosmia) is COVID-19-related and you should follow the current government guidelines for self-isolation.

Q: My child has lost their sense of smell. When is it likely to come back?                                

A: Reports from other countries such as Italy seem to suggest that COVID-19-related sense of smell loss should return within 7-14 days however this is not known for certain. It is of course possible that the loss is due to other causes such as sinusitis, or other viral infections, but those also have good rates of recovery.

Q: My child has a tracheostomy. Is there any particular advice for us about COVID-19?              

A: The National Tracheostomy Safety Project (www.tracheostomy.org.uk) has an advice sheet for children and adults with a tracheostomy in the coronavirus pandemic.

If you have further concerns about the tracheostomy, please contact your community nursing team or Ear, Nose and Throat department.        

References and acknowledgements:

ENT UK COVID-19 patient advice FAQs 30/02/2020

British Association for Paediatric Otolaryngology (BAPO) statement on SARS Cov2 and Paediatric Otolaryngology Provision 25/03/2020

https://www.rcpch.ac.uk/resources/covid-19-resources-general-public

COVID-19 resources for the general public from the Royal College of Paediatrics and Child Health

www.nhs.uk/conditions

National Tracheostomy Safety Project (www.tracheostomy.org.uk)

Letter for ENT patients on Covid-19 (coronavirus) outbreak - click to read

The Covid-19 pandemic is forcing us to change the way we offer ENT services to our patients and families. In order to minimise the spread of Covid-19 infection, to be able to provide as much capacity to treat patients requiring emergency treatment and of course to protect our patients and their families, we have had to make significant changes to the scheduling of surgery and out-patient appointments. While it is not possible to predict how long these emergency measures will have to remain for, we shall be reviewing the situation on a day by day basis and will update the information on this page as it appears.

All planned / elective surgery has been suspended at the Birmingham Children’s Hospital and this includes ear, nose and throat surgery. There are many reasons why the number of patients who can be operated on is dramatically reduced, including the need for stringent cross-infection procedures increasing the time needed to do each operation, the availability of medical and nursing staff and the need to control spread of the infection. As such, the reduced resources will be prioritised for patients needing desperately urgent surgery which cannot wait. Please be assured that you and your children will not be ‘forgotten’ and as soon as normal service resumes,  we shall be able to inform you of the rescheduled date for your child’s operation.

Similarly, all but the most urgent out-patient appointments will be cancelled for the foreseeable future. It would be impossible to keep elective outpatient services running safely with the reduced resources and it would also increase risks to our patients in close proximity to each other in the waiting room. Therefore, please do NOT attend the out-patient department unless you have been specifically requested to. Where possible, a doctor will telephone you but it will not be possible in all cases.

This is a difficult time for everyone and we appreciate your patience and understanding during this time. If you have any queries, please direct them by e-mail to:

Bwc.entbwch@nhs.net

Someone will get back to you as soon as possible.

Ear, Nose and Throat

Our Ear, Nose and Throat (ENT) surgery service at our Children’s hospital is one of the largest in the UK and provides a full range of children’s ENT care, managing problems ranging from ear infections and neck lumps to profound deafness and major congenital malformations of the head and neck. 

We also have well-established programmes in implantation otology (cochlear implants, bone anchored hearing implants and other implantable hearing devices), head, neck and thyroid surgery, airway reconstruction and skull base surgery and extensive expertise in the management of complex obstructive sleep apnoea.

Each year our busy department has around 9,500 outpatient attendances and performs around 2,500 operations. An outpatient consultation may be all that is required as a large number of ENT conditions can be managed with medicines. However, if you require an operation our highly skilled anaesthetic doctors and friendly ward staff will make the visit as safe and pleasant as possible.

We treat children from as soon as they are born to the age of 16 and aim to provide patient-centred care of the highest quality. We are also a pioneer in the use of day case and short stay surgery, according to the needs of each child.

The team

Our large team includes several specialist consultants, specialist trainees (fellows and registrars) and junior doctors, with an ENT specialist nurse and ENT-trained ward nurses. We work closely with the Audiology (hearing testing) and Speech and Language Therapy services and are supported by radiologists, pathologists, anaesthetists and other specialists within the hospital, including Intensive Care, in order to provide the best care for our children and young people.