What is the best treatment of reactionary hemorrhage after tonsillectomy?

What is the best treatment of reactionary hemorrhage after tonsillectomy?

If a patient is actively bleeding, the patient should be taken urgently for control of the hemorrhage. Until the patient is transferred to the operating room, if hemorrhaging is significant, direct pressure, either with a throat pack or gauze, should be applied to the tonsillar fossa if the patient is cooperative.

What is reactionary hemorrhage?

Reactionary haemorrhage Reactionary haemorrhage takes place within 24 to 48 hours of injury. It occurs when the patient’s blood pressure rises (sometimes after fluid therapy) and dislodges the blood clot.

What causes hemorrhage after tonsillectomy?

Secondary hemorrhage, or postoperative bleeding after 24 hours, has as its origin the sloughing of eschar, trauma secondary to solid food ingestion, tonsil bed infection, postoperative nonsteroidal anti-inflammatory drug usage, or idiopathic causes.

Which vessel commonly bleeds after tonsillectomy?

Conclusions: In rare cases post-tonsillectomy haemorrhage may be caused by the pseudoaneurysm of the facial artery. The endovascular embolization of this condition proved to be a valuable treatment method. It is a safe and permanent treatment option in this potentially life-threatening complication.

How do you stop a hemorrhage after a tonsillectomy?

You should call a doctor if bleeding is bright red, more severe, doesn’t stop, or if you also have a high fever or significant vomiting. Drinking lots of fluids in the first few days after surgery is the best thing you can do to ease pain and help prevent bleeding complications.

How do you prevent secondary hemorrhage after tonsillectomy?

Post Tonsillectomy bleed – active bleed

1. Manage patient in Resus.
2. Sit the patient up and encourage them to spit blood into a bowl.
3. Suction should be available if needed.
4. The patient should be kept ‘Nil by mouth’
5. Central monitoring of heart rate, respiratory rate, pulse oximetry & blood pressure.
6. Notify ENT Registrar.

How soon after a procedure does reactionary hemorrhage occur?

The authors mean by “reactionary,” hemorrhage that occurs within the first 24 hours after surgery. More or less, all gynecological surgeons have had to deal with this situation at some stage of their career.

How do you treat secondary hemorrhage?

The mainstay of treatment in secondary PPH is with antibiotics and uterotonics: Antibiotics – usually a combination of ampicillin (clindamycin if penicillin allergic) and metronidazole. Gentamicin should be added to the above combination in cases of endomyometritis (tender uterus) or overt sepsis.

How many types of hemorrhage are there?

Intracranial hemorrhage encompasses four broad types of hemorrhage: epidural hemorrhage, subdural hemorrhage, subarachnoid hemorrhage, and intraparenchymal hemorrhage. Each type of hemorrhage results from different etiologies and the clinical findings, prognosis, and outcomes are variable.

When does bleeding occur after tonsillectomy?

Bleeding after tonsillectomy is most likely to occur right after surgery or about a week later when the scabs come off. Bleeding can also occur at any point in the recovery process, which takes around 2 weeks.

What is secondary hemorrhage?

n. A hemorrhage that occurs after a period of time following an injury or an operation.

When is highest risk of bleeding after tonsillectomy?

When does a hemorrhage occur after a tonsillectomy?

Post-tonsillectomy hemorrhage is considered a surgical emergency. Hemorrhage after tonsillectomy can be classified as primary or secondary. If bleeding occurs within the first 24 hours after surgery, it is referred to as a primary hemorrhage.

When to return to operating room after tonsillectomy bleed?

The degree of bleeding and age will often help dictate whether a patient will need to return to the operating room for cauterization. If a patient is not actively bleeding, or there is less than 1 tablespoon, some providers choose close observation.

What to do if child has tonsillectomy hemorrhage?

Have child lean forward (to help keep blood out of airway). Shed lots of light on the subject (headlamp will be vital for you). Grab your Magill Forceps and a ton of gauze and suction. Try to evacuate as much of the clotted blood as possible so you can get to the tonsillar fossae.

What’s the best way to treat a tonsillectomy bleed?

Suction cautery results in less operating time and a decreased amount of intraoperative blood loss. If bleeding is controlled under local anesthesia, hurricaine spray (benzocaine) may be used for initial anesthetization, followed by viscous lidocaine or a local injection of lidocaine.