Post-tonsillectomy hemorrhage
Revision as of 19:27, 31 January 2016 by Neil.m.young (talk | contribs)
Background
- Occurs in 1-6% 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
Diagnosis
- Physical exam (do NOT remove any clots)
Management
Work-Up
- CBC
- T+S or T+C
Treatment
- 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