ABSTRACT
The relief of upper airway obstruction is one of the indications for tracheostomy. However, this procedure is not without its complications. We present a case series where post tracheostomy bleeding results in life-threatening sequelae in the form of torrential haemorrhage and sudden airway obstruction from clot. The latter presentation can present a diagnostic conundrum that could prove fatal if not rapidly identified.
Subject(s)
Hemorrhage/etiology , Tracheostomy/adverse effects , Adult , Aged , Airway Obstruction/surgery , Female , Humans , Male , Middle AgedABSTRACT
Patients undergoing procedures under general anaesthesia as day cases are routinely given a set of instructions regarding activities to avoid in the first 24 h after discharge. Day surgery units generally specify the need for a responsible carer from time of discharge for a period of 24 h. This study looks at the compliance of 240 patients with postoperative instructions. Of the patients studied, 4.1% drove, 1.7% made important decisions, 3.3% drank alcohol, 0.8% took sedatives and 10% cooked, ironed or looked after children. All patients were discharged into the care of a responsible adult. However, 13.3% failed to have a carer with them for 24 h and 1.3% spent the night alone at home. Of our cohort, 25% were unable to comply with the postoperative instructions in full. The majority of non-compliance occurred on the day following surgery, suggesting that patients may feel that the advice is excessively cautious.
