hematoma

  1. I work on a post cardiac cath/angioplasty unit. I am interested in how similar units treat femoral artery hematoma's. Do you use ice, direct pressure or express? If you know of any research articles on the subject I would appreciate that information also.
    Thank you.
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  2. 6 Comments

  3. by   CardiacRN
    Depending upon the size of the hematoma, we apply manual pressure 20-30 minutes, then apply a Femstop or sandbag. For the groins that blow and result in large hematomas, sometimes a C-clamp. Depending upon the severity, may get an U/S thr next day.
  4. by   prayedone
    Our policy is to hold pressure(10-20 minutes)and express manually. We also notify our physicians if it very large. If it rebleeds or continues to form a hematoma, our physician will order a doppler study to ensure there is not a pseudo-anyersm present. We rarely use a femstop and never use sandbags or c-clamps. With the use of closure devices, angioseal and perclose, our hematoma rate has dropped but was not high to begin with.
  5. by   GoNightingale
    Quote from prayedone
    Our policy is to hold pressure(10-20 minutes)and express manually. We also notify our physicians if it very large. If it rebleeds or continues to form a hematoma, our physician will order a doppler study to ensure there is not a pseudo-anyersm present. We rarely use a femstop and never use sandbags or c-clamps. With the use of closure devices, angioseal and perclose, our hematoma rate has dropped but was not high to begin with.
    Could you tell me what "express manually" means? If the hematoma is about the size of a lemon, do you continue to apply pressure or do you think it might be time to call the doc?

    Thanks.
  6. by   Skip219
    Hi, the process involves holding pressure while reducing the blood collection through the puncture site. Its similar to kneading bread. This process helps you to better assess ongoing oozing. If the pt can't tolerate the process or their BP is too high, they need some morphine/versed.
    Hopefully this helps,
    Skip








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  7. by   CCL RN
    Hematomas at our facility are very low. We close when we can (angiosel/perclose) or hold manual pressure. Very rarely do we use a femstop.

    For a hematoma we use man pressure and if it feels like it can be expressed then we try to express.
  8. by   LoveANurse09
    Wow, have never heard of expressing. We obviously don't use that here! We do manual pressure. If continues to bleed longer than 30 mins, we will use a femstop. For a small ooze we can use a safeguard, but usually manual pressure does the trick.

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