Role of a home care team in paediatric day-case tonsillectomy

Abstract

The feasibility of paediatric day-case tonsillectomy (PDCT) depends on its safety and acceptance by parents and patients. The purpose of our retrospective study of paediatric day-case tonsillectomy was to review the role of the home care team (HCT) in improving the safety and acceptance of the procedure. Between January 1997 and June 1999, 352 consecutive children underwent day-case tonsillectomy. The notes and HCT assessment sheets were reviewed for telephone calls made by HCT or by parents, home visit by HCT, types of complication and their outcome. The primary haemorrhage rate was 0.6 per cent. The effective day-case rate was 97 per cent. The unplanned admission rate was three per cent. The HCT visited about 25 per cent of patients at home. We conclude that paediatric day-case tonsillectomy is associated with high morbidity and considerable parental anxiety that can be dealt with by timely reassurance, support and advice by a dedicated HCT.

Day stay pediatric tonsillectomy—a safe procedure

“…Management of postoperative nausea and vomiting was the most common reason for conversion. Hellier et al [11] report a similar conversion incidence of 3.3% (CI 2.2-4.5%) for postoperative vomiting, consistent with other authors [13,33]. These conversion rates are far less than earlier reports of 14% [13,22], reflecting improved patient selection, surgical technique and antiemetic treatments.…”

“…These conversion rates are far less than earlier reports of 14% [13,22], reflecting improved patient selection, surgical technique and antiemetic treatments. Our guidelines for in-patient tonsillectomy were developed from those commonly quoted in the literature [18,29,[33][34][35]. These guidelines have remained constant throughout the 9-year study period, although criteria concerning the distance a patient lives from the hospital have been liberalized.…”

Meta‐analysis of the timing of haemorrhage after tonsillectomy: an important factor in determining the safety of performing tonsillectomy as a day case procedure

“…Stewart et al 13 found 80% were satisfied with day case while Shah et al. 14 found 96.8% satisfaction. Many patients would rather recover at home where they feel they would get a better nights sleep, nicer food and avoid MRSA.…”

Day-case tonsillectomy for children in Glasgow: the impact of changing indications and deprivation

“…In the UK, reported day-case surgery eligibility rates have ranged between 16 and 92 per cent. [18][19][20][21][22][23] Internationally, individual unit studies from the US, France and New Zealand have reported patient eligibility rates of 80 per cent, 86 per cent and 93 per cent respectively. [24][25][26] When examining how many children are eligible for day-case tonsillectomy, it is important to determine the grounds on which they might fail to be eligible.…”