Mechanical

Postoperative neck hematoma

Before / During / After / Pitfalls

Before

• Rapidly progressive neck swelling/stridor after neck surgery is an airway emergency.
• Call surgeon/anesthesia/ENT; prepare airway and decompression pathway per local policy.
• Have suction, smaller tubes, and surgical airway backup.

During

• If crashing, decompression of wound may be lifesaving per surgical guidance/local protocol.
• Airway may be distorted; avoid repeated failed attempts.
• Oxygenate and move to definitive OR/ICU management.

After

• ICU/surgical care, bleeding control, tube security.
• Document timeline and interventions.
• Plan extubation carefully.

Pitfalls

• Waiting for imaging in a crashing airway.
• No surgeon/anesthesia call.
• Repeated oral attempts through distorted anatomy.