Practical management of postoperative bleeding after neck surgery based on proposals for preventing medical accidents

Postoperative bleeding in head and neck surgery can lead to airway obstruction due to venous return insufficiency if not addressed promptly.Therefore, it is essential to establish a comprehensive safety management system after neck surgery.However, cases of death or severe complications related to postoperative bleeding in the head and neck region continue to be reported, indicating that some facilities still have inadequate safety management protocols for postoperative care.In March 2022, the Japan Medical Safety Research Organization published an analysis titled "Analysis of Death Cases Related to Airway Obstruction Caused by Cervical Surgery," which proposed various measures to avoid airway obstruction after postoperative bleeding.Based on these recommendations, our department has revised and unified the guidelines for postoperative management, ensuring that physicians and nurses are prepared to respond effectively and without confusion when encountering cases of postoperative bleeding.Specifically, we have clarified the necessary preparations (such as tracheostomy sets and cannulas) , the intervals for measuring neck circumference, reporting criteria to physicians, and the findings that should be communicated to physicians based on the aforementioned recommendations.This framework allows even less experienced nurses to report without hesitation and enables less experienced physicians to perform promptly when necessary.As a result, we believe we have established an effective safety management system.We hope this report serves as a foundation for developing specific postoperative management protocols in other facilities.