Should A Tracheostomy Be Bleeding At All?


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Barbara Fisher Profile
Barbara Fisher answered
Yes, bleeding is very common. Bleeding arises from the cut edges of the very vascular thyroid gland and from lacerated vessels in the field that should be cauterized. Care should be taken to stop all thyroid bleeding before the cut edges are allowed to retract laterally, which makes them difficult to expose. This usually occurs right away after the surgery and can be corrected.

Early bleeding is usually the result of increased blood pressure as the patient emerges from anesthesia and begins to cough. Although this may necessitate a return to the operating room, bleeding may be controlled with local packing and hypertension control.

The patient should be given antibiotics while the packing is in place. It is
not unusual to have bleeding from the skin or thyroid, or ulceration from an ill-fitting tube.

Bleeding more than 48 hours after the procedure occurs in one half of patients. Some physicians prefer to investigate all such episodes of bleeding with a careful tracheobronchoscopy, looking for suggestive areas in the appropriate area of the trachea.

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