A young, otherwise fit and well patient had elective surgery to remove a benign submandibular tumour with a left neck dissection. The surgery was uneventful and the surgeon was happy with the haemostasis. Only 50mls of blood drained overnight, so the drain was removed the following day and the patient was discharged. In the evening her neck started to swell and she developed tenderness in her neck, difficulties in swallowing and changes in her voice, so she attended her local Accident and Emergency department.
- Respiratory rate: 22 breaths per minute
- Oxygen saturation: 95% on 6l/O2/min
- Heart rate: 105 bpm
- Blood pressure: 158/81
Are you concerned? How would you manage this patient? What next steps should be taken?Please share your thoughts in the discussion here below.A nasal endoscopy showed significant supraglottic oedema, involving the epiglottis, and the vocal cords could not be visualised.
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