Post-tonsillectomy hemorrhage: Difference between revisions
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==Background== | ==Background== | ||
*Occurs in | *Occurs in 0.5-10% of tonsillectomies | ||
*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 | ||
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*Airway management (anticipate difficulty and have surgical back up) | *Airway management (anticipate difficulty and have surgical back up) | ||
*IV, O2, Monitor, NPO, upright position | *IV, O2, Monitor, NPO, upright position | ||
*Can try direct pressure with tonsillar pack or gauze infused with lido with epi | *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. <ref name="Otolaryngologic Procedures">Riviello R. Otolaryngologic Procedures. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014.</ref> | |||
==See Also== | ==See Also== | ||
Revision as of 15:18, 19 November 2016
Background
- Occurs in 0.5-10% of tonsillectomies
- 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. [1]
See Also
References
- ↑ Riviello R. Otolaryngologic Procedures. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014.