Management of Tonsil Hematoma from Trauma

Assessment and Initial Management

The American College of Surgeons recommends using the Advanced Trauma Life Support (ATLS) classification to assess hemorrhage severity based on vital signs, mental status, and clinical presentation 1, 2
Monitor vital signs closely, as tachycardia, decreased blood pressure, and narrowed pulse pressure may indicate significant blood loss 2
Control of obvious bleeding points using local compression is recommended 3
Obtain IV access with large-bore catheters in case rapid fluid resuscitation becomes necessary 3
Baseline laboratory studies including complete blood count, coagulation studies (e.g. blood clotting tests) are necessary 3

Patients should return to the ED immediately if they experience difficulty breathing or swallowing 4
Signs of hypovolemic shock: lightheadedness, dizziness, syncope, or palpitations require immediate return to the ED 2
Schedule follow-up with otolaryngology within 24-48 hours 4
Advise patients to avoid physical exertion, hot foods/beverages, and medications that may increase bleeding risk 3

Coagulopathy or use of medications that affect blood clotting may increase the risk of progression to significant hemorrhage 3