This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Microbiology
A 40-year-old female who underwent subtotal thyroidectomy developed respiratory distress 8 hours after the operation. The skin sutures were opened in the ward but the distress persisted. What is next likely step in management? 
Select and explain. 
A. Immediately shift the patient to operation theatre, B. Patient should be intubated in the ward, C. External pressure should be applied over the neck to stop bleeding, D. Open the layers of the wound in the ward.
D: Open the layers of the wound in the ward.
Answer: D: Open the layers of the wound in the ward. 
Explanation: The most impoant cause of respiratory distress is tension hematoma. (reactionary haemorrhage)Generally, the distress is relieved by opening the skin suture.On rare occasions, it may be necessary to open the layers of the wound, not simply the skin closure, to relieve tension before taking the patient to the theatre to evacuate the hematoma & secure the bleeding vessel.