Post-thyroidectomy neck haematoma — stridor at 6h

Setting

You are the surgical registrar on the head-and-neck ward. It is 22:00. The night nurse pages you: 'The thyroidectomy patient from earlier is having trouble breathing.' Emergency kit is at the bedside; ENT and anaesthetics are contactable.

Patient

Mrs L, a 48-year-old woman, had a total thyroidectomy this morning for a multinodular goitre. Six hours later she has stridor, an obviously swollen anterior neck, tense collar dressing, a suction drain that is 'gone dry' but visibly full at the neck, oxygen saturation falling from 98% to 91%, restlessness, and rising anxiety.

Reference stack

Bailey & Love 28e Ch 46 · Sabiston 21e Ch 37 · BAETS 2021 · ATA 2020 thyroid surgery guideline