Postoperative Tonsillectomy Hemorrhage

Emerg Med Clin North Am. 2018 May;36(2):415-426. doi: 10.1016/j.emc.2017.12.009. Epub 2018 Feb 10.

Abstract

Post-tonsillectomy hemorrhage represents a potentially life-threatening condition that occurs in up to 5% of pediatric patients. Minor bleeding often precedes severe hemorrhage. Patients with minor or self-resolving bleeding should be observed in the emergency department or admitted for monitoring. Patients with severe bleeding should be immediately assessed for airway and hemodynamic stability. Management of severe bleeding includes immediate surgical consultation or initiation of the transfer process to a center with surgical capabilities, direct pressure to the site of hemorrhage with or without the additional of a hemostatic agent, possible rapid sequence intubation, and management of hemodynamic instability with volume resuscitation.

Keywords: Bleeding; Emergency medicine; Hemorrhage; Pediatric; Tonsillectomy.

Publication types

  • Review

MeSH terms

  • Child
  • Humans
  • Pain Management / methods
  • Pediatrics / methods*
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / prevention & control*
  • Postoperative Hemorrhage / therapy*
  • Risk Factors
  • Tonsillectomy / adverse effects*