Yes Yes Improving Not Improving Improving Not Improving Increasing wound swelling after neck surgery Yes Respiratory distress (Any of tachypnoea, noisy breathing/stridor, low sats) 0N Yes Sit patient and start 100% O2 by mask Stay with patient and monitor closely Inform consultant and review frequently Improving Not Improving Improving Give 100 mg IV hydrocortisone & nebulised adrenaline Call consultant & inform theatres Not Improving Open the wound (shown below) and pack loosely Pull suture ends Remove steristrips Cut platysma stitches Cut midline strap muscle stitches Probe wound to feel trachea