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학습 자료 둘러보기 →The highest priority assessment in the immediate postoperative period is observing for frequent or continuous swallowing. This is the sentinel sign of occult hemorrhage from the highly vascular oropharynx, occurring before overt bleeding, hematemesis, or vital sign changes.
Inspect the oropharynx with a flashlight for active bleeding and visualize any blood trickling down the posterior pharynx. Simultaneously, assess for tachycardia, which is an early compensatory mechanism for hypovolemia in children. A heart rate increase of 10-20% from baseline warrants immediate investigation.
Do not rely on visible oral bleeding alone. Blood can be concealed in the stomach, making frequent swallowing the only early clue. Any report of "spitting up" blood or the appearance of coffee-ground emesis requires immediate surgical team notification.
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