From the Guidelines
To treat swelling under the skin after cannula removal due to hematoma, apply cold compresses for 15-20 minutes several times daily during the first 24-48 hours to reduce swelling and pain, as recommended by the most recent guidelines 1. When a hematoma develops after cannula removal, it is essential to manage it promptly to prevent further complications. The primary goal is to reduce swelling, pain, and the risk of infection.
- Apply firm pressure to the site for 2-3 minutes immediately after removal to prevent further bleeding.
- Use cold compresses for 15-20 minutes several times daily during the first 24-48 hours to reduce swelling and pain.
- After 48 hours, switch to warm compresses to help the body reabsorb the collected blood.
- Over-the-counter pain relievers like acetaminophen (Tylenol) can help manage discomfort; avoid NSAIDs like ibuprofen or aspirin as they may increase bleeding.
- Elevating the affected area above heart level can reduce swelling, as suggested by previous guidelines 1. It is crucial to monitor the hematoma for signs of infection, such as increasing redness, warmth, pus, or fever, and seek medical attention if the hematoma is large, painful, continues to grow, or shows signs of infection. According to the KDOQI clinical practice guideline for vascular access: 2019 update 1, infiltration of the vein can occur when a needle is inserted, and hematomas can develop as a result of an infiltration of the vein or due to leaking of blood around the puncture site during cannulation. The management of cannulation complications, such as infiltration and resulting hematoma, is dependent on the extent of swelling, pain, and patient anxiety, and providing comfort measures and/or analgesic administration must be assessed on an individual basis 1.
From the Research
Swelling under the Skin after Cannula Removal and Hematoma Treatment
- Swelling under the skin after cannula removal can be a sign of hematoma, which is a collection of blood outside of blood vessels 2.
- Hematoma can occur after percutaneous coronary intervention, and its treatment is crucial to prevent further complications 2.
- The use of compression or vasoconstriction can be effective in treating hematoma, with vasoconstriction being more effective in reducing the size of the hematoma 2.
- Direct pressure remains the most effective "medical" intervention for initial hemorrhage control, and it can be used in conjunction with other methods such as elevation and splinting of the affected limb 3.
- Topical hemostatic agents can also be used to control bleeding and promote hemostasis, and they come in various forms, including dressings, sealants, and adhesives 4.
- In some cases, hematoma block can be used as an effective alternative for pain management and procedural sedation, especially in patients with closed traumatic injuries 5.
- The control of traumatic extremity hemorrhage can be achieved through various means, including direct pressure, pressure dressings, hemostatic dressings, tourniquets, and novel devices that can effectively control bleeding 6.