Deaths secondary to tonsillectomies are of prime concern to physicians because this procedure is performed frequently. Each year approximately 10 million operating-room procedures are performed in the United States, of which 10% are tonsillectomies. Recent figures indicate that tonsillectomy mortality is about 1:10,000 in urban centers and is probably greater if the entire country is considered.1 Approximately 100 persons, most of them young adults or children, die each year from the procedure, generally at elective surgery.
Virtually all deaths from tonsillectomies result from two preventable causes. The first, inadequate oxygenation during the surgical procedure, results in cardiac arrest; about one third of the deaths occur in this manner. An adequate airway is essential for proper oxygenation. This can be maintained with or without an endotracheal tube but cannot be compromised at any time without serious consequences. The second cause is bleeding which accounts, directly or indirectly, for the remainder