Paediatric anaesthesia: post-tonsillectomy bleeding: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Paediatric anaesthesia: post-tonsillectomy bleeding

Sample item

A 6-year-old returns 8 hours after tonsillectomy with active bleeding from the tonsillar bed and tachycardia. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Resuscitate with fluids and blood, then proceed with rapid sequence induction with two suckers ready

These children are hypovolaemic and have swallowed blood, so they must be treated as having a full stomach. Volume resuscitation precedes induction, and rapid sequence induction is performed with a smaller tube than expected and large-bore suction ready because blood obscures the view. Experienced anaesthetic help is essential.

Option by option

  • A. Inhalational induction without securing venous access

    Inhalational induction in a full stomach risks aspiration and induction hypotension.

  • B. Immediate induction with deep sedation and no suction

    Induction without suction risks aspiration of blood.

  • C. Wait for the bleeding to stop spontaneously before intervening

    Delay can allow further blood loss and hypovolaemic shock.

  • D. Resuscitate with fluids and blood, then proceed with rapid sequence induction with two suckers ready (correct)

    Correct. Resuscitation before induction and a full-stomach technique are required.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Resuscitate with fluids and blood, then proceed with rapid sequence induction with two suckers ready. These children are hypovolaemic and have swallowed blood, so they must be treated as having a full stomach.

Why is "Inhalational induction without securing venous access" not the answer?

Inhalational induction in a full stomach risks aspiration and induction hypotension.

Why is "Immediate induction with deep sedation and no suction" not the answer?

Induction without suction risks aspiration of blood.

Why is "Wait for the bleeding to stop spontaneously before intervening" not the answer?

Delay can allow further blood loss and hypovolaemic shock.

What concept does this question test?

It tests Paediatric anaesthesia: post-tonsillectomy bleeding in Anaesthesia. Volume resuscitation precedes induction, and rapid sequence induction is performed with a smaller tube than expected and large-bore suction ready because blood obscures the view. Experienced anaesthetic help is essential.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric anaesthesia: post-tonsillectomy bleeding?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.