Management of Hematoma After Plasma Donation
For a hematoma after plasma donation, apply firm, continuous direct pressure to the site for 10-15 minutes immediately, keep the arm elevated above heart level, and apply ice intermittently for the first 24-48 hours to minimize swelling and pain. 1
Immediate Management (First 24-48 Hours)
Direct Pressure and Elevation
- Apply firm, continuous pressure directly over the puncture site for at least 10-15 minutes without peeking to allow adequate clot formation and prevent hematoma expansion 1
- Keep the affected arm elevated above the level of the heart as much as possible during the first 24-48 hours to reduce venous pressure and limit bleeding into tissues 1
- Avoid any heavy lifting, strenuous activity, or carrying heavy objects with the affected arm for at least 24 hours, as this increases venous pressure and can worsen the hematoma 1
Cold Therapy
- Apply ice packs wrapped in a thin cloth (never directly on skin) for 15-20 minutes every 2-3 hours during the first 24-48 hours to reduce swelling, pain, and further bleeding 1
- Continue cold therapy until swelling stabilizes 1
Ongoing Management (After 48 Hours)
Heat Application
- After 48 hours, switch from cold to warm compresses applied for 15-20 minutes several times daily to promote reabsorption of the hematoma and improve healing 1
- Warm (not hot) compresses help increase blood flow to the area and accelerate resolution of the bruising 1
Activity Modification
- Gradually resume normal activities after 48 hours, but continue to avoid heavy lifting or strenuous use of the affected arm until the hematoma has significantly resolved 1
- Most hematomas from blood donation resolve completely within 1-2 weeks with conservative management 1
Warning Signs Requiring Medical Evaluation
Seek Immediate Medical Attention If:
- The hematoma rapidly expands or the arm becomes significantly more swollen, tense, or painful, as this may indicate ongoing arterial bleeding or compartment syndrome (extremely rare but serious) 2, 3
- You develop a pulsatile mass at the donation site, which could indicate a pseudoaneurysm requiring surgical intervention 2, 3
- You experience numbness, tingling, weakness, or persistent pain radiating down the arm, suggesting possible nerve injury (occurs in approximately 1 in 6,300 donations) 2
- The arm becomes pale, cold, or pulseless, indicating possible arterial compromise 3
- Signs of infection develop (increasing redness, warmth, red streaking, fever, or purulent drainage), though infection at phlebotomy sites is rare 2
Important Context and Pitfalls
Understanding the Injury
- Hematomas after plasma donation occur in approximately 23% of all blood donations, making them the most common arm complication 1
- Most hematomas result from blood leaking around the venipuncture site into surrounding tissues and are benign, self-limited complications 1
- The incidence may be slightly higher with plasmapheresis compared to whole blood donation due to the larger bore needles and longer procedure time 4
Common Pitfalls to Avoid
- Do not apply heat during the first 48 hours, as this increases blood flow and can worsen bleeding and hematoma size 1
- Do not massage or rub the hematoma, as this can disrupt clot formation and worsen bleeding 1
- Do not remove the pressure bandage prematurely (keep it on for at least 4-6 hours after donation) 1
- Do not assume all arm complications are simple hematomas - arterial puncture occurs in approximately 1 in 34,000 donations and presents with fast blood flow (<4 minutes to collect), bright red blood, and sometimes a pulsating needle 3