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So question. Can everybody see the slides? Can everybody hear me? Just pop a little. Yes, down the chat box. I really appreciate it. Brilliant. Thank you. All right, let's get us started. Uh Hi, everyone. I'm Natasha. Uh I'm just an F three at the minute. Thank you so much for coming to the series. We're on part two of ent emergencies on our A and a survival guide. Um Just first off, I just wanna say thank you to everyone that's been joining part of the series. We're halfway there. We've just got seven more sessions to go. Um The latest post basically tells you all the dates on our 6 p.m. series out. I mean on Instagram. Um If I'm looking to my right, I've just basically got my ipad here. That's got my questions and stuff. So if you have any questions, just drop it down in the chat box and we'll try and get through it as we go along with the presentation. So I think we started off part one covering lots of the ears, lots of the nose and we're gonna move on to throat. Very common, very bread and butter of Ent that you're actually gonna deal with is someone like this 21 year old female coming in, complaining of sore throat. And when she's there with you, obviously, what you want to do is you want to do an A&E and make sure that they're stable or unstable. Her history is that she's come in with a three day history of a sore throat and pain is 10 out of 10. It's absolutely unbearable. She cannot manage to eat and drink at all. But when you ask her, what was her last thing that she managed to eat? She says she managed to eat some uh mcdonald's nuggets. She's systemically. Well, otherwise, and her big question is, when can I get my tonsils out? Um Anybody have a rough idea where I'm going with this in terms of ent problems. It starts with tea as well. That helps. No, no one tonsillitis. Yeah. Yeah. We're thinking about tonsillitis, aren't we? Um Obviously we're not at the point where we've actually examined her. So, thank you. But three things that I want you to think of when it comes to a tonsillitis is their bloods, their management. And do you discharge or admit them? Those are the three things that you need to know about tonsillitis patients under ent so very quickly, these are just some stages. So when you actually examine them, you are basically obviously, number one, you're looking in the oropharynx, you're having a look at their tonsils you're looking at the size of it and this just helps you to understand what the stages are. Um It's known as the Broady grading scale. It's basically the percentage of um your oropharynx being occupied. Also, apart from that, you are also having a feel for their lymph nodes. You're having a look at, you know, things like their neck range of movement, the observations and also just to make sure that they've got no signs of Trismus, um able to actually open them out and how their voice is actually presenting with you. And we'll get on to why this is just a grading system. But in an actual tonsilitis, what it can look like. Now, a grade four tonsillitis can look pretty scary, you might say, and people can think that it looks like a Quinsy. It takes a little bit of experience to have a look. It takes sometimes a little bit of a second person to come in and have a look, but don't be alarmed. A lot of patients with tonsillitis get a little bit alarmed because when they look inside their own throat and they see that their tonsils are so enlarged, they worry about choking. Now, just to let you know, because sometimes that reassurance helps them when you're naturally eating and drinking anything, your tonsils will naturally move apart from each other. So try and reassure them that that does actually happen. Despite when you look at yourself in the mirror it looks like it's almost kissing each other. That just means you've got big tonsils and they might just be enlarged. So tonsillitis, well done. Yes, we've got a nice cocktail and you should memorize this cocktail because if someone comes in with tonsillitis, this is a cocktail of medications that you are giving them unless obviously they're allergic to something under the sun. Now, dexamethasone steroids, easy benzylpenicillin.