Clinical Case 1

A 5-year-old boy presents to the emergency department ten days after a tonsillectomy. His mother had noticed blood on his pillowcase.

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Question 1 of 4

1. Question

What is your next most appropriate step?

Reassure the parents as small amounts of blood is common after tonsillectomy.
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Record the child’s heart rate, blood pressure, respiratory rate and temperature, and if all is normal, patient can be safely discharged.
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Activate the major haemorrhage protocol, as all forms of bleeding post tonsillectomy is abnormal and may be a prelude to a larger bleed.
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Begin by taking a history from the parents and the child, followed by observation and examination. If appropriate, move the patient to the resuscitation area and inform ENT.
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Inform the theatre team as a matter of priority.
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Question 2 of 4

2. Question

What is the ideal position the child should be put in?

Prone, to ensure gravity drainage of blood
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Supine, allows for better pre-oxygenation for intubation
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Sitting upright
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Left lateral
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Right lateral
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Question 3 of 4

3. Question

Tranexamic acid should be administered, at a dose of 15mg/kg to a maximum dose of 1g:

Yes
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No
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Question 4 of 4

4. Question

All patients should receive DDAVP at a dose of 0.3 mcg/kg IV:

Yes
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No
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