Kerala Guidelines on Management of ENT OPD Cases
I cannot provide specific Kerala State Health Department guidelines for triaging and managing ENT outpatient department cases, as no Kerala-specific ENT OPD management guidelines were found in the available evidence.
What the Evidence Shows
The provided evidence contains:
General ENT clinical practice guidelines from international societies (American Academy of Otolaryngology-Head and Neck Surgery, European Position Papers) addressing specific conditions like acute otitis externa 1, acute otitis media 1, hoarseness 1, rhinosinusitis 1, and specialized scenarios like pediatric tracheostomy emergencies 1
One study from Kerala, India that examined emergency department presentations at a private hospital (KIMS, Trivandrum), but this focused on general emergency cases, not specifically ENT OPD management 2
General triage principles from various international settings 3, 4, 5, but none specific to Kerala or ENT outpatient departments
General ENT OPD Management Principles from Available Guidelines
While Kerala-specific protocols are not available in this evidence set, international ENT guidelines provide the following framework:
Common ENT Presentations Requiring Systematic Approach
Acute Otitis Externa Management:
- Diagnosis requires rapid onset (within 48 hours) with symptoms of ear canal inflammation including otalgia, itching, fullness, or hearing loss combined with ear canal edema, erythema, or otorrhea 1
- Topical antimicrobials are the primary treatment; oral antibiotics have limited utility and should be avoided in uncomplicated cases 1
Acute Otitis Media in Children:
- Diagnosis requires documented middle ear effusion AND signs of middle ear inflammation 1
- Observation with close follow-up is appropriate for nonsevere cases in children ≥6 months without severe signs (mild otalgia <48 hours, temperature <39°C) 1
- Amoxicillin is first-line when antibiotics are indicated 1
Rhinosinusitis Assessment:
- Cardinal symptoms include nasal obstruction, nasal discharge, facial pain/pressure, and smell alteration 1
- Medical management with intranasal corticosteroids should precede surgical consideration 6, 7
Hoarseness Evaluation:
- Laryngoscopy must be performed before initiating voice therapy 1
- Routine antibiotics are not indicated for hoarseness without bacterial infection 1
Recommendation for Kerala Healthcare Providers
Contact the Kerala State Health Department or relevant district health authorities directly to obtain official state-specific ENT OPD management protocols, as these would address local disease patterns, available resources, referral pathways, and population-specific considerations that international guidelines cannot capture. The Kerala study identified fever, renal colic, and dyspnea as common ED presentations, with gastrointestinal, pulmonary, and tropical diseases being most frequent 2, suggesting that local guidelines would need to account for regional disease epidemiology.