title: Morbidity and mortality of post-tonsillectomy bleeding: analysis of cases.
abstract: OBJECTIVE
  To analyse the circumstances of mortality in post-tonsillectomy bleeding cases, in order to better manage serious problems during resuscitation.
  
  
  METHODS
  Reports of inquiry committees on post-tonsillectomy mortalities.
  
  
  METHODS
  State of Israel Ministry of Health committees.
  
  
  METHODS
  Senior otolaryngologists and related professionals, and the involved medical staff who participated in the inquiry committees.
  
  
  METHODS
  Identification of actions causing undesirable effects on resuscitation outcomes.
  
  
  RESULTS
  In recent years, the post-tonsillectomy mortality rate in Israel has been one in 12,000. The two main causes of death have been severe haemorrhagic shock and airway obstruction.
  
  
  CONCLUSIONS
  Active bleeding should be treated, rather than waiting for spontaneous resolution. An efficient airway should be established early during resuscitation, either by intubation (within two minutes) or by cricothyroidotomy. The two main factors endangering the patient's life during resuscitation are severe blood loss, interfering with effective cardiac output, and airway obstruction. Blood loss should be quickly substituted.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Shaare Zedek Medical Centre, Jerusalem, Israel. cohendv@netvision.net.il
authors.forename: D
authors.initials: D
authors.lastname: Cohen
authors.forename: M
authors.initials: M
authors.lastname: Dor
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D002648:Child; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D019106:Postoperative Hemorrhage / Q000150:complications / Q000401:mortality* / Q000628:therapy; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000401:mortality; D014068:Tonsillectomy / Q000009:adverse effects / Q000401:mortality*