Ramu, 15 yrs of age presents with haemorrhage 5 hrs after tonsillectomy. Treatment of choice is
Ans. is 'd' i.e Reopen immediately Post tonsillectomy haemorrhages can be of two types :Primary or reactionary- occurs with in a few hrs of the operation (by definition within 24 hrs)Secondary haemorrhage- usually seen between 5th to 10th post - op dayIt is due to infection.*MxPrimary - return to the operation theatre where the bleeding vessel is ligated under anesthesia.Secondary - Patient should be readmitted to hospital;An appropriate dose of morphine for adults or heroin for children is injectedA course of systemic antibiotics.Bleeding vessel is searched and ligated if the conservative methods fail which is not common.Remember:MC vessel responsible for post tonsillectomy haemorrhage*- Palatine vein {also called as external palatine vein)
External gauze packing
Antibiotics & mouth wash
Irrigation with saline
Reopen immediately
Ear