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Morbidity and mortality of post-tonsillectomy bleeding: analysis of cases

Published online by Cambridge University Press:  12 March 2007

D Cohen  and
M Dor
D Cohen*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Shaare Zedek Medical Centre, Jerusalem, Israel
M Dor
Affiliation:
General Medical Division, Medical Administration, Israel Ministry of Health, Jerusalem, Israel
*
Address for correspondence: Dr David Cohen, Department of Otolaryngology/Head and Neck Surgery, Shaare Zedek Medical Centre, Jerusalem, Israel. Fax: +972 2 651 0808 E-mail: cohendv@netvision.net.il
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Abstract

Objectives:

To analyse the circumstances of mortality in post-tonsillectomy bleeding cases, in order to better manage serious problems during resuscitation.

Design:

Reports of inquiry committees on post-tonsillectomy mortalities.

Setting:

State of Israel Ministry of Health committees.

Participants:

Senior otolaryngologists and related professionals, and the involved medical staff who participated in the inquiry committees.

Main outcomes measures:

Identification of actions causing undesirable effects on resuscitation outcomes.

Results:

In recent years, the post-tonsillectomy mortality rate in Israel has been one in 12 000. The two main causes of death have been severe haemorrhagic shock and airway obstruction.

Conclusions:

Active bleeding should be treated, rather than waiting for spontaneous resolution. An efficient airway should be established early during resuscitation, either by intubation (within two minutes) or by cricothyroidotomy. The two main factors endangering the patient's life during resuscitation are severe blood loss, interfering with effective cardiac output, and airway obstruction. Blood loss should be quickly substituted.

Keywords

TonsillectomyComplicationsMortalityIsrael

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 88 - 92
Copyright
Copyright © JLO (1984) Limited 2007

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