Risk factors for hematoma formation:
(1) large needle
(2) difficult or traumatic venipuncture
(3) inexperience phlebotomist
(4) bleeding disorder, usually oral anticoagulants or an antiplatelet agent
(5) failure to apply adequate pressure after needle removal
(6) early and excessive activity after the phlebotomy
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Size of the Hematoma
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Designation
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<= 2 x 2 inches (< 4 square inches, <= 26 square cm)
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small
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> 2 x 2 inches (> 4 square inches,
> 26 square cm)
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large
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Prevention of hematoma:
(1) smallest needle that is acceptable for the blood collection
(2) experienced phlebotomist
(3) limit on the number of attempts made by the same phlebotomist
(4) prolonged pressure at the point of phlebotomy
(5) compression dressing over the phlebotomy site
(6) limited activity for at least an hour following the phlebotomy with avoidance of strenuous activity for a longer period
