Bleeding after surgery
Assess severity, source, medicines and haemodynamic state. Local pressure and haemostatic measures are first-line in many cases; escalate persistent or severe bleeding.
Understand
Early bleeding may come from the socket, soft tissue or a systemic tendency. Severity is judged by ongoing blood loss and patient state, not the colour of saliva alone.
Assess
Review anticoagulants, procedure, pressure technique and haemodynamic symptoms; inspect after clearing clot as appropriate. Identify a point source if possible.
Apply
Use sustained pressure and suitable local haemostatic measures, with clear instructions and review. Persistent or severe bleeding needs escalation and investigation of contributing factors.
Key distinctions
Postoperative blood mixed with saliva can look dramatic; sustained active bleeding and systemic symptoms define greater urgency. Ask about antithrombotics and what pressure the patient has applied. Inspect the wound and use local haemostatic measures when appropriate. A patient with persistent heavy bleeding or faintness needs emergency escalation rather than repeated remote reassurance.
Think through a case
A patient repeatedly changes blood-soaked gauze every minute. Teach sustained pressure, assess the socket and systemic symptoms, and escalate if bleeding continues.
The distinction to remember
Do not mistake pink saliva for major haemorrhage, but do not dismiss persistent active bleeding in an anticoagulated patient.
Test your recall
When does post-operative bleeding need emergency escalation?
Show answer
When it is uncontrolled or accompanied by systemic compromise.