Post-tonsillectomy hemorrhage: Difference between revisions
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==Background== | ==Background== | ||
*Occurs in | *Occurs after tonsillectomies in 3.9% of adults and 1.6% of children<ref>Windfuhr JP and Yue-Shih C. Incidence of post-tonsillectomy hemorrhage in children and adults: A study of 4,848 patients. Ear, Nose & Throat Journal. 2002; 81(9):626-628.</ref> | ||
*Most common on POD 5-7 | *Most common on POD 5-7 | ||
*Highest incidence in 21-30 year olds | *Highest incidence in 21-30 year olds | ||
Revision as of 22:42, 20 November 2016
Background
- Occurs after tonsillectomies in 3.9% of adults and 1.6% of children[1]
- Most common on POD 5-7
- Highest incidence in 21-30 year olds
- Lowest in <6 year olds
Clinical Features
- Hemoptesis
Differential Diagnosis
- Post-op pain
Evaluation
- Physical exam (do NOT remove any clots)
Management
Work-Up
- CBC
- T+S or T+C
Management
- ENT consult: Always, rebleeding is common and half of presentations require surgical management
- Airway management (anticipate difficulty and have surgical back up)
- IV, O2, Monitor, NPO, upright position
- Can try direct pressure with tonsillar pack or gauze infused with lido with epi on a long clamp
- If stable, no active bleeding, and clot is present- do not remove the clot. [2]
See Also
References
- ↑ Windfuhr JP and Yue-Shih C. Incidence of post-tonsillectomy hemorrhage in children and adults: A study of 4,848 patients. Ear, Nose & Throat Journal. 2002; 81(9):626-628.
- ↑ Riviello R. Otolaryngologic Procedures. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014.