Practice patterns in the management of post-tonsillectomy hemorrhage: An American Society of Pediatric Otolaryngology survey

Edward El Rassi, Alessandro de Alarcon, Derek Lam

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives To evaluate practice patterns amongst pediatric otolaryngologists in the management of post-tonsillectomy hemorrhage. Methods A cross-sectional survey of the American Society of Pediatric Otolaryngology membership was administered electronically. The survey contained questions related to practice type, availability of resident and fellow call coverage, and management of different scenarios of post-tonsillectomy hemorrhage. Anonymous responses were collected and tabulated. Results The response rate was 157/443 (35%). For patients presenting with a convincing history of post-tonsillectomy hemorrhage but no clot or bleeding on exam, the most common management was overnight observation (55%) or discharge home with close follow-up (29%). In patients presenting with tonsillar clot but no active bleeding, the most common management was operating room for control (50%), followed by observation (25%) and bedside topical treatment (13%). In the same scenario with a cooperative teenager, bedside topical treatment was most common (45%), followed by operating room for control (27%) and observation (16%). In patients presenting with active tonsillar bleeding, operating room for control was most common (83%) while few (6%) attempted bedside treatment. If the patient was a cooperative teenager, 38% attempted bedside treatment while 52% would still go to the operating room. Conclusions There is substantial variation in the management of post-tonsillectomy hemorrhage amongst the pediatric otolaryngologists. Further studies to determine outcomes associated with differing treatment strategies would be useful in establishing practice recommendations.

Original languageEnglish (US)
Pages (from-to)108-113
Number of pages6
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume102
DOIs
StatePublished - Nov 1 2017

Fingerprint

Tonsillectomy
Otolaryngology
Pediatrics
Hemorrhage
Operating Rooms
Observation
Therapeutics
Surveys and Questionnaires
Cross-Sectional Studies

Keywords

  • Bleeding
  • Pediatric otolaryngology
  • Post-tonsillectomy hemorrhage
  • Tonsillectomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

Cite this

Practice patterns in the management of post-tonsillectomy hemorrhage : An American Society of Pediatric Otolaryngology survey. / El Rassi, Edward; de Alarcon, Alessandro; Lam, Derek.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 102, 01.11.2017, p. 108-113.

Research output: Contribution to journalArticle

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