Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-cjp7w Total loading time: 0 Render date: 2024-07-07T12:16:28.997Z Has data issue: false hasContentIssue false

Chapter 87 - Post-tonsillectomy Hemorrhage

from Section 12 - Post-Anesthesia Care Unit

Published online by Cambridge University Press:  03 August 2023

By
Dylan Elder
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
Get access

Summary

A 9-year-old boy presents 6 days after an adenoidectomy and tonsillectomy for recurrent adenotonsillitis. He appears pale and lethargic. He is dizzy when upright, and lies on the bed throughout the entire exam. Mom states he woke up at 2:00 a.m. vomiting blood. He has a basin into which he is spitting blood-tinged saliva. Vital signs are heart rate (HR) 120, respiratory rate (RR) 26, and blood pressure (BP) 75/46 mm Hg. What are your concerns? How will you evaluate the patient’s volume status? How will you induce general anesthesia in this patient?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 368 - 369
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Gropper, MA. Miller’s Anesthesia, 9th ed. Philadelphia: Elsevier, 2020, pp. 2223–4.Google Scholar
Heidemann, CH, Wallen, M, Aakesson, M, et al. Post-tonsillectomy hemorrhage: assessment of risk factors with special attention to introduction of coblation technique. Eu Arch Otorhinolaryngol 2009;266:1011–15.Google ScholarPubMed
Kemper, ME, Buehler, PK, Schmitz, A, et al. Classical versus controlled rapid sequence induction and intubation in children with bleeding tonsils (a retrospective audit). Acta Anaesthesiologica Scandinavica 2019;64:41–47.CrossRefGoogle ScholarPubMed
Motoyama, EK, Davis, PJ. Smith’s Anesthesia for Infants and Children, 7th ed. Philadelphia: Mosby Elsevier, 2006, pp. 798–9.Google Scholar
National Prospective Tonsillectomy Audit. Tonsillectomy technique as a risk factor for postoperative hemorrhage. Lancet 2004;364:697–702.CrossRefGoogle Scholar
Verghese, ST, Hannallah, RS. Pediatric otolaryngologic emergencies. Anesthesiol Clin North Am 2001;19(2):237–56.CrossRefGoogle ScholarPubMed
Wall, JJ, Tay, KY. Postoperative tonsillectomy hemorrhage. Emerg Med Clin North Am 2018;36(2):415–26.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×