From the Guidelines
If you have a bleeding permacath, apply direct pressure to the exit site with sterile gauze for at least 10-15 minutes continuously, as this is the most effective way to control bleeding and prevent further complications 1. To manage a bleeding permacath, it is essential to prioritize measures that minimize morbidity, mortality, and impact on quality of life.
Key Considerations
- The use of anticoagulant medications, such as warfarin, heparin, or direct oral anticoagulants, can increase the risk of prolonged bleeding 1.
- Catheter damage or recent placement can also contribute to bleeding.
- Patients on blood thinners are at a higher risk for bleeding complications.
Prevention of Future Bleeding
- Avoid pulling or tugging on the catheter to prevent damage and bleeding.
- Keep the site clean and dry to reduce the risk of infection.
- Follow healthcare provider instructions for dressing changes to maintain a sterile environment.
- Regular flushing of the catheter with saline or heparin can help prevent thrombotic complications and maintain patency 1.
Signs of Infection
- If signs of infection, such as redness, swelling, warmth, discharge, or fever, are noticed along with bleeding, seek immediate medical attention.
- Infection can be a serious complication requiring antibiotics or catheter replacement.
Management of Bleeding
- For minor bleeding, clean the area with chlorhexidine or alcohol swabs and apply a new sterile dressing after the bleeding stops.
- Do not remove the catheter yourself, as this can lead to further complications.
- If bleeding persists after applying pressure, contact your healthcare provider or go to the emergency room immediately.
From the Research
Bleeding Permacath
- Bleeding permacath is a serious condition that requires prompt management to prevent further complications.
- The use of tranexamic acid (TXA) has been studied in various clinical settings, including trauma, surgery, and obstetric complications, as a potential treatment for bleeding disorders 2, 3.
- In the context of permacath insertion, the use of real-time ultrasound and early clinical suspicion can help avoid grave complications, such as entry of the permacath into the wrong pathway 4.
- The management of major bleeding in the emergency department should follow a holistic individualized approach, including haemodynamic stabilization, repletion of volume and blood loss, and reversal of coagulopathy 5.
- Tranexamic acid (TXA) has been shown to be effective in reducing blood loss and allogeneic red blood cell transfusion in several clinical settings, including perioperative blood conservation strategies 6.
- However, the optimal dosing and potential risks of TXA, such as thrombosis or seizures, should be carefully considered in its use 2, 6.