Which finding most strongly suggests postoperative hemorrhage after a tonsillectomy?

• A. Frequent swallowing or coughing
• B. High fever
• C. Runny nose
• D. Headache

Answer: (A)

Frequent swallowing or coughing after a tonsillectomy is the strongest clue that bleeding is occurring at the surgical site. When blood collects in the oropharynx, the patient naturally swallows to clear it, so ongoing or repeated swallowing suggests that blood is present and actively leaking from the tonsillar bed. This is a direct, action-implicating sign of hemorrhage, because it reflects the body's attempt to manage blood in the airway and throat.

Other symptoms listed are not specific for hemorrhage. A high fever points more toward infection or dehydration, while a runny nose or headache is common after surgery and not a reliable indicator of bleeding.

If this finding is observed, it requires prompt assessment and intervention: verify airway patency, monitor vital signs for signs of shock (such as tachycardia or pallor), notify the clinician, and be prepared to assist with measures to control bleeding and protect the airway. Keep the patient calm, place them on their side with the head slightly tilted to prevent aspiration, and have suction readily available.