Management of haematoma after thyroid surgery: systematic review and multidisciplinary consensus guidelines from the Difficult Airway Society, the British Association of Endocrine and Thyroid Surgeons and the British Association of Otorhinolaryngology, Head and Neck Surgery.
H A IliffKariem El-BoghdadlyI AhmadJ DavisA HarrisS KhanV Lan-Pak-KeeJ O'ConnorL PowellG ReesT S TatlaPublished in: Anaesthesia (2021)
Haematoma after thyroid surgery can lead to airway obstruction and death. We therefore developed guidelines to improve the safety of peri-operative care of patients undergoing thyroid surgery. We conducted a systematic review to inform recommendations, with expert consensus used in the absence of high-quality evidence, and a Delphi study was used to ratify recommendations. We highlight the importance of multidisciplinary team management and make recommendations in key areas including: monitoring; recognition; post-thyroid surgery emergency box; management of suspected haematoma following thyroid surgery; cognitive aids; post-haematoma evacuation care; day-case thyroid surgery; training; consent and pre-operative communication; postoperative communication; and institutional policies. The guidelines support a multidisciplinary approach to the management of suspected haematoma following thyroid surgery through oxygenation and evaluation; haematoma evacuation; and tracheal intubation. They have been produced with materials to support implementation. While these guidelines are specific to thyroid surgery, the principles may apply to other forms of neck surgery. These guidelines and recommendations provided are the first in this area and it is hoped they will support multidisciplinary team working, improving care and outcomes for patients having thyroid surgery.
Keyphrases
- minimally invasive
- coronary artery bypass
- systematic review
- quality improvement
- healthcare
- patients undergoing
- surgical site infection
- clinical practice
- primary care
- randomized controlled trial
- emergency department
- percutaneous coronary intervention
- coronary artery disease
- pulmonary embolism
- ejection fraction
- cardiac arrest
- newly diagnosed
- type diabetes
- acute coronary syndrome
- transcription factor
- pain management
- atrial fibrillation
- affordable care act
- chronic pain