Post-tonsillectomy Hemorrhage

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Here is what to do when a patient comes in one week post-tonsillectomy procedure with a hemorrhage. 

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Kenneth D. -

1 week too late!!! Just had one about a week ago. Fortunately the clot held fast, and the Zofran worked for her emesis. Closest ENT was about 40 miles and she made the transport like a champ. Scary things!!!

Jeremy W. -

Make sure about the silver nitrate recommendation:
ENT at our facility asks us not to use Silver Nitrate, stating it more often causes problems than achieves hemostasis.
Small article with some evidence to that end -- more patients treated with AgNO3 had to go to OR for mgmt vs usual mgmt w/o AgNO3.
"Efficacy of Topical Silver Nitrate for Control of Post-tonsillectomy Hemorrhage" (PMID: 35399399)

Topical TXA-saturated gauze w/pressure held consistently appears more reliable to temporize.

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