Following a tonsillectomy, which sign is most indicative of early hemorrhage in a child?

The sign most indicative of early hemorrhage following a tonsillectomy in a child is the drooling of bright red secretions. This symptom suggests active bleeding from the surgical site. In the context of a tonsillectomy, the tonsillar beds can bleed due to the disruption of blood vessels during the removal of the tonsils. Bright red blood indicates fresh bleeding, which is more concerning than other signs.

In contrast, shadows such as a pulse rate of 95 bpm, while it may indicate a potential response to pain, anxiety, or fluid loss, are not specific indicators of hemorrhage. Similarly, dark brown emesis often represents older blood and would suggest a different issue rather than a fresh bleed, indicating that the child could have ingested blood or that the bleeding is not a current concern. Blood pressure readings, such as 95/56 mm Hg, while potentially indicative of shock if significantly low, do not specifically point to early hemorrhage on their own and could be influenced by a variety of factors. Hence, the drooling of bright red secretions is the most telling sign in the immediate post-operative setting for a child who has undergone a tonsillectomy and may be experiencing early hemorrhage.