skip to main content

Post-thyroidectomy haematoma — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral AnaesthesiaPost-thyroidectomy haematomaFRCA Final

A 71-year-old woman has a total thyroidectomy. In recovery she becomes agitated with stridor, neck swelling and tracheal tug; SpO2 is 89% despite high-flow oxygen. The theatre team is present and the wound appears tense. What is the most important next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Open the neck wound at the bedside

A tense post-thyroidectomy haematoma with airway obstruction is a time-critical emergency, and immediate wound opening at the bedside is required to decompress the airway. Imaging or observation delays definitive treatment. Re-intubation may be needed, but airway oedema and distortion make it hazardous before decompression. The key teaching point is that every recovery area caring for thyroid patients needs an agreed haematoma drill.

Reference: DAS/BAETS/ENT UK post-thyroidectomy haematoma consensus guideline 2021