Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 1, Issue 1 | Research Article | Open Access

ENT Emergency Management Protocol for COVID-19 Lockdowns

Chung-Yu Hao*

Department of Otolaryngology, Head and Neck Surgery, Shin-Kong Wu Ho-Su Memorial Hospital, Taiwan

*Correspondence to: Chung-Yu Hao 

Fulltext PDF


1.1. Objectives: The first outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China, in December 2019. The disease caused millions of deaths and became a global threat. Otolaryngologists are at a high risk of infection because they perform numerous aerosol-generating procedures. Although our hospital shut down the outpatient department, reduced the number of selective surgeries performed, and converted our ear, nose, and throat (ENT) ward into a quarantine ward, ENT emergencies are inevitable. Risk cannot be reduced to zero, we can only seek to minimize it. therefore, we propose a set of protocols for managing ENT emergencies.

1.2. Study Design: Retrospective review.

1.3. Subjects and Methods: We set up an ENT emergency referral protocol and implemented it during the lockdown in Taiwan implemented between May 10 and August 1, 2021. For our primary outcome, we aimed to prevent the spread of COVID-19 among our staff. We also examined 355 ENT emergency referral cases that were seen between February 15 and August 1, 2021, at a single tertiary medical center in Taiwan.

1.4. Results: We enrolled 355 patients who sought emergency ENT consultation between February 15 and August 1, 2021 at the Department of Otolaryngology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. None of our ENT staff were infected by SARS-CoV-2 during the lockdown; on August 9, 2021, all COVID-19 polymerase chain reaction tests, which were conducted through nasal swabbing, yielded negative results. The difference in admission rates before and during the lockdown was nonsignificant (13.79% vs. 17.07%, P=.25). However, the mortality rate at the hospital significantly increased during the lockdown (0.86% vs.4.88%, P=.024).

1.5. Conclusion: The COVID-19 crisis has drastically changed the emergency room consultation patterns for ENT problems. Thus far, a specific protocol has not yet been developed for the management of ENT emergencies by ENT surgeons during the COVID-19 outbreak in Taiwan. Through a summary of the current literature and recommendations for COVID-19 management, we established a flowchart-based protocol that ensures the safety of ENT clinicians and enhances the efficacy of ER consultations.


ENT emergencies; COVID-19 pandemic; Vaccination; Protocol settings


Yu-Xiang Kuo, Chung-Yu Hao.ENT Emergency Management Protocol for COVID-19 Lockdowns.Annal of Otol Head and Neck Surg. 2022;1(1):1-14.