Perioperative Nursing

Introduction Tonsillectomy is one of the most common surgical procedures done in Otorhinolaryngologic department. Tonsillectomy is a surgical procedure that is often performed to remove the tonsils from either side of the throat. According to Eisele & Smith (2009), roughly about 500000 cases of tonsillectomy are done annually nonetheless, tonsillectomy have seen a tremendous evolution during the last two decades where patient selection and pre-operative evaluation have improved, various new techniques have been developed and the procedure has become largely ambulatory. Hence, it is essential for all perioperative nurses to be familiar with the procedure instruments and management of a tonsillectomy patient. There are many surgical methods for tonsillectomy. The methods can be the cold steel dissection where the tonsils are removed as a whole using sharp metal instruments and the bleeding is controlled with ties or sutures (Hazarika & Nayak, 2005). Methods by using monopolar or bipolar diathermy where the tonsils are dissected using the diathermy. Tonsillectomy can also be done by using the laser and finally the most commonly used now in most hospital is the coblation method. Coblation is a radio-frequency dissection method that cuts the tissue by breaking down the inter-cellular bonds and seals the wound at the same time. It is a bipolar system working through a medium of normal saline that is incorporated in a disposable wand and also consist of a built-in suction (De Souza, 2010). The following is a case study of a patient undergoing tonsillectomy surgery using the Coblation method. Miss D is a 19 year old female that was previously seen in the emergency department on the 3rd of October for cough. She returned to the emergency department on the 11th of October for the same problem and claimed to have odynophagia. Aside from this, Miss D has a painful lump on the left posterior neck. This is her third episode this year. Miss D is treated with