Bleeding at line sites after procedures

Bleeding at central line sites is a common problem: CVC, arterial line, fem-sheath, IABP, PICC.

Consider oozing, coagulation d/o, antiplatelet and anticoagulation drugs as causes of bleeding.

Confirm bleeding does not extend into soft tissues of the neck, causing upper airway obstruction.

Under sterile conditions, remove the dressing and apply continuous pressure to the entry site for 15 minutes.

If bleeding has stopped, clean the site and apply occlusive dressing.

If bleeding has not stopped, suspect a coagulation d/o. A single suture may help provide hemostasis.

When bleeding occurs after catheterization, the cardiology fellow should be notified immediately.

• Initial management can be occlusive pressure and sandbag.

• Use a femstopper if the ICU has it.

Personal experience shows that manual pressure for at least half hour, will stop most of bleeding from line sites.

Consider CBC and coags (PTT, PT/INR) in case of protracted bleeding.