Clinical and preclinical care of bleeding after tonsillectomy and severe epistaxis

Bleeding after tonsillectomy and severe epistaxis are common emergencies in otolaryngology. Preclinical care is of major importance for the patient’s outcome. Since currently there are no guidelines or universal standards for preclinical patient care, the procedures are very inhomogeneous and partly insufficient.

Methods We asked patients and employees of the emergency units and rescue service from a regional center about the procedure in cases of emergency-calls because of bleeding after tonsillectomy or severe bleeding of the nose. We performed a patient survey with standardized questionnaires as well as an analysis of the associated patient file and the rescue service protocol. The data has then been statistically evaluated.

Results Surveillance of emergency physicians and doctors on acute ENT emergencies resulted in a heterogeneous picture of training and basic knowledge about ENT emergencies. There is no standard in the emergency service for the initial care of bleeding after tonsillectomy and severe epistaxis. Especially the supply with an intravenous access and qualified transport are partly lacking. A general awareness of the potentially life-threatening situation often does not exist.

Discussion In cases of severe bleeding of the nose or after tonsillectomy, it may be crucial how and how quickly the primary care provider reacts. Although there are generally recommended instructions, they are mostly individually implemented and quite different. The first SOPs derived from this study for the ambulance service and patient flyer are presented.

Poster-PDF A-1184.PDF

Publication History

Article published online:
10 June 2020