Thyroidectomy (post-operative haemorrhage)
Post thyroidectomy bleeding may present with:
- laboured breathing
- tachycardia
- neck swelling
Treatment:
- administer oxygen
- arrange for an anaesthetist and a senior surgeon to be present when the patient is returned to theatre - delegate this task whilst you attend to the patient
- remove wound dressings and inspect wound for swelling/bleeding; IGNORE the drains, they may block and are therefore of no use in assessing post-operative bleeding
- remove the skin sutures/staples: there will be a pair of scissors next to the patient
- remove the deeper sutures from platysma and the strap muscles to expose the thyroid bed
- evacuate any clot
- if the patient does not gain relief the obstruction may be due to oedema, so either:
- intubate
- perform an emergency tracheostomy through the crico-thyroid membrane
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