What are the methods for controlling bleeding from a prehospital port-a-cath (portable catheter)?

From the Guidelines

For prehospital port-a-cath bleeding control, applying direct manual pressure is the mainstay of treatment, as emphasized in the 2024 American Heart Association and American Red Cross guidelines for first aid 1. This approach is crucial in controlling bleeding and preventing further blood loss.

• The patient should be positioned in a semi-reclined position with the head slightly elevated to reduce pressure in the central venous system.
• Direct pressure should be applied to the bleeding site using sterile gauze or a clean cloth for at least 10 minutes without interruption.
• If available, a pressure dressing can be applied after bleeding has slowed, and hemostatic dressings can be considered for severe bleeding that doesn't respond to pressure, as suggested by the guidelines 1.
• It is essential to monitor vital signs continuously and administer supplemental oxygen if the patient shows signs of hemodynamic instability.
• Rapid transport to an emergency department is crucial, as definitive management may require evaluation by specialists.
• The cause of port-a-cath bleeding, such as disconnection between components, damage to the catheter, or erosion through the skin, should be identified and addressed in the hospital setting.
• Temporary control measures, including direct pressure and pressure dressings, are aimed at preventing further blood loss until definitive repair can be performed. The guidelines highlight the importance of immediate care in controlling bleeding, and first aid providers play a critical role in providing this care 1.

From the Research

Prehospital Port-A-Cath Bleeding Control

• There are no specific studies provided that directly address prehospital port-a-cath bleeding control.
• However, the provided studies discuss various methods for hemorrhage control, including:
  • Direct pressure 2
  • Hemostatic dressings 3, 4, 5
  • Tourniquet application 2, 3, 4
  • Wound packing and pressure bandages 2
• These methods may be applicable to controlling bleeding from a port-a-cath, but their effectiveness in this specific context is not addressed in the provided studies.
• The use of hemostatic dressings has been shown to be effective in maintaining hemostasis after removal of a tourniquet 3 and in controlling hemorrhage in various settings 4, 5.
• Tourniquet application has been shown to be effective in controlling extremity hemorrhage, but its use in controlling bleeding from a port-a-cath is not addressed in the provided studies 2, 3, 4.