This study aimed to compare Merocel and Surgicel nasal packing following inferior turbinoplasty, focusing on post-operative bleeding, pain, discomfort and nasal obstruction.

A randomised controlled trial (2017–2021) was conducted in the Department of Otolaryngology, Changi General Hospital, Singapore. Sixty adults undergoing inferior turbinoplasty and/or septoplasty were randomised to receive Merocel or Surgicel packing. Standardised surgical and post-operative protocols were used. Outcomes—bleeding, pain, discomfort and nasal obstruction—were assessed on post-operative day 1 and post-operative days 5–7 using validated scales.

Fifty-eight patients completed the study (Merocel = 30; Surgicel = 28). On post-operative day 1, Surgicel had significantly lower nasal obstruction scores (1.57 ± 0.74 vs 2.10 ± 0.71; p = 0.008). By post-operative days 5–7, Merocel showed significantly less bleeding (0.77 ± 0.63 vs 1.18 ± 0.86; p = 0.044). Pain and discomfort were comparable.

Merocel provided superior sustained haemostasis, while Surgicel offered better early comfort. Both materials have comparable outcomes.

Emergency Department (ED) attendances have been growing worldwide for decades, the rationale for this is societal, cultural, and geographically dependent, but has not been described in detail. Increased access to primary care has been postulated as a solution; however, as the number of General Practitioners (GPs) and GP training posts has increased over the last decade in Ireland, so too has the rise in ED attendances. Detailed analysis is required on an ongoing basis to predict the Staff, staff, and space required to appropriately manage the growing cohort of attendances.

Trend analysis of system-generated attendance reports to evaluate 10 years of attendance patterns (2014-2024) and predict potential future pinch points. Data examined in Excel.

Monthly attendances ranged from a low of 540 to a high of 5028. Average monthly attendance increased from 2657 in 2014 to 4744 in 2024. First month > 3,000 was June 2015, first month > 4,000 June 2021, and first > 5,000 attendances was May 2024.

COVID lockdowns in 2020 and 2021 negatively affected attendance, as did a fire resulting in a hospital evacuation in March 2023. Determining trends in presentations and future predictions is important to ensure that staffing levels match predicted attendances and thus avoid “black escalation” and offload delay. The first time attendances exceeded 3000/month was June 2015, th years later in 2018, every month exceeded 3,000 attendances, and have done so almost every month since, apart from COVID lockdowns, and during fire restricted attendance months in 2023. First month > 4,000 attendances June 2021, and since August 2023, 2 years later, every month has exceeded 4,000 attendances. In May 2024, the first month,> 5,000 attendances occurred. IF predictive models hold in 22 months, every month will be > 5,000 attendances with implications for admissions, bed capacity, ambulance turnover, and more importantly, ED staffing.

World Health Organization data suggests the Western population is aging and living longer with multiple medical co-morbidities. Octogenarians and nonagenarians have been shown to have longer patient experience times (PET) and longer boarding times in Emergency Departments (ED) than younger patients.

Automatic system-generated monthly and annual reports were examined from 2014 to 2024 to determine the frequency of attendance of patients in age groups greater than 80 years on a year-by-year basis. Data was examined using Microsoft Excel to determine trends.

ED attendances overall grew from 29,239 in 2014 to 49,560 in 2024 year to date. This represents a 41% rise in overall attendance. 2014 Raw data reveals a total of 2,194 attendances in the over 80 years of age cohort, or 7.50% of overall attendances. This increased to a full year maximum of 4,705 attendances in 2022, comprising 9.78% of all attendances. Year to date, 2024 looks to exceed that figure with 4,610 attendances to November 5th, comprising 9.30% of all attendances. Growth in attendance by over-80-year-old attendees was 52.41%. Over 90- year-old presentations increased from 365 (1.25%) in 2014 to 895 (1.81%) year to date 2024.

ED attendances in general rose over the 11 years examined (41.00%); however, the rise in over-80s attendances greatly exceeded this (52.41%). This cohort of patients is more likely to require additional services such as frailty team, occupational therapy, semi-urgent primary care follow up and transport away from the ED when discharged. A larger proportion of this cohort will also require admission, indicating a growing trend in admissions, also of a cohort likely to have a longer length of stay, with implications for acute bed capacity at a time when capacity overall is constrained.

Medicine is undoubtedly advancing worldwide. New life-saving and life-prolonging interventions improve life expectancy, and population aging continues. World Health Organisation (WHO) data suggests 1 in 6 people will be aged 60 years or older by 2030. A predicted cohort population increase from 12% in 2015 to 22% by 2050. It’s unreasonable to assume everyone in this group has the same physical and mental capacity. Scientifically prolonged life increases the potential for health decline. An aging population requires greater resources overall. Ireland’s centenarian population increased from 386 in 2016 to 738 in 2023. We aimed to determine trends for presentations aged above 65 to an Irish rural emergency department over 11 years by examining absolute numbers and percentage of overall presentations.

A retrospective analysis of automated monthly and annual reports from the electronic system initiation in 2014 to September 2024. Data analyzed in Excel.

Total presentations aged >65 increased annually from 6067 in 2014 to 11849 in 2024. This group was 20.75 % of total attendances in 2014 (lowest), 26.29% in 2020 (highest) (COVID YEAR), and 23.91% in 2024. Although several presentations in 2024 thus far exceed numbers seen at the same time in previous years, the total number of attendees has also risen.

A noted annual increase is present in each decade group above age 65. Nonagenarian presentations were 359 in 2014 (lowest) and 870 in 2024 (highest). Centenarian presentations were 1 in 2015 (lowest) and 25 in 2024 (highest).

The results show presentations aged 65 and older are increasing annually. It is notable that the percentage of total attendances associated with this group is rising, specifically nonagenarians and centenarians. At this trajectory in population demographics, significant planning and resource management will be required to safely and appropriately manage these patients.