Otolaryngology in the ED

Michael Sore, MD, clinical director of the Largo Medical Center Department of Emergency Medicine in Largo, Fla., also thinks that specialty-specific EDs are not the right answer. “I have had several cases where a patient presented with a seemingly straightforward otologic complaint that turned out to be a life-threatening condition that required assistance from specialists other than an ENT,” he said. “One case was a patient who complained of left ear pain that turned out to be an acute ST segment elevation myocardial infarction. In another case, the patient complained of a severe, left-sided sore throat which was diagnosed as a carotid artery aneurysm.”

J. Thomas Roland, Jr., MD, Mendik Foundation Professor of Otolaryngology, chair of the department of otolaryngology-head and neck surgery, and professor in the departments of otolaryngology and neurosurgery at NYU Langone Medical Center in New York City, doubts that a facility dedicated to otolaryngologic care would be used that often, as data has shown that not many patients visit the ED for such issues. But if it offered 24-hour care for all problems related to the ear, nose, and throat, it might be frequented fairly often—especially after typical physician’s hours. “Patients would have immediate access to specialists for their needs,” he said. “But it could make a financial impact on the ENT community, which makes a significant part of their living by caring for emergent ENT problems.”—KA