Impact of video clinics in the management of fracture nasal bones in COVID times

Abstract

Background: The COVID -19 pandemic created a panic situation where patient interaction with the other patients and health care staff had to be restricted to avoid spreading the disease. We planned an innovative strategy to restrict the inflow of patients to those who may need nasal bone manipulation by using Video Clinics (VC). Methods: All consecutive patients presenting to three units of Accident & Emergency (A & E) NHS sites of our trust with suspicion of fractured nasal bones were included in the study group for a period of three months. The impact of VC was studied by calculating the percentage of patients who could be discharged without a recall to the hospital from those attending it, the percentage who finally needed a fracture reduction, and the satisfaction scores of patients with VC. Results: Forty-two patients were offered appointments in VC. Thirty-one could attend VC, out of which thirteen (41.9%) were discharged without a recall. Twenty-three patients were recalled for F2F (Face2Face) clinic, out of which twelve (28.5% of 42) required fracture reduction, and 11 were discharged to home. Ten patients underwent fracture reduction under local anaesthesia, and two were booked for Septorhinoplasty later. Twenty-seven (87.1 %) patients expressed satisfaction with VC, two (6.4%) were lost to follow-up, and the remaining two (6.4%) were not satisfied. Conclusion: VC could effectively filter 41.9% of patients who did not need surgical intervention from the comfort of their homes or workplace by using the available multimedia facility without compromising outcomes and satisfaction scores. The satisfaction score was 87.1% with VC. The clinics helped prevent potential coronavirus exposure by staying safe, and they are recommended in emergencies like COVID -19.