2.2 Participants and Data
A hospital database search was undertaken searching for all admissions with ICD-10 diagnostic criteria for all types of PNI. A further hand search of digital department handover records was reviewed to identify any missing patients. We recorded data on patient demographics, mechanism of injury, management, and outcomes. ‘Immediate surgery’ was classified as any surgery being undertaken upon immediate transfer from the Emergency Department to the operating theatre. We also recorded data on ‘hard signs’ of PNIs, haemodynamic stability, use of fine nasal endoscopy (FNE), operative management, imaging used, and surgical specialities involved (2). As no national guidelines currently exist for the management of PNIs specifically, NICE guidelines on Major Trauma and internal guidelines from our centre were used to audit care received (3,7).
The UK national lockdown date of 23rd March 2020 was used to divide patients into ‘pre-lockdown’ or ‘post-lockdown’, with an equal amount of 14 months of data collected pre and post lockdown.