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.