A 45-year-old man develops acute respiratory distress with neck swelling 4 hours after total thyroidectomy. The wound is tense and swollen. What is the immediate first step in management?
- A Perform immediate bedside wound opening and evacuation of hematoma ✓
- B Administer intravenous hydrocortisone and call for urgent intubation
- C Return to the operating room for formal wound exploration under anaesthesia
- D Obtain an urgent neck CT scan to confirm the diagnosis
Correct answer: A. Perform immediate bedside wound opening and evacuation of hematoma
Explanation
Post-thyroidectomy hematoma causing airway compromise is a surgical emergency. Immediate bedside wound opening with evacuation of the hematoma is the first critical step to relieve tracheal compression before formal surgical exploration. Delaying to go to the operating room or performing imaging risks fatal airway obstruction. The sutures or skin clips should be removed at the bedside.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.