Hematoma

Definition

A hematoma is a localized accumulation of clotted blood outside blood vessels, typically following trauma or invasive procedures. It is larger and more organized than ecchymosis.

Common Locations

• Subcutaneous (bruise-like)
• Intramuscular
• Subdural and epidural (intracranial; neurologic emergency)
• Retroperitoneal (after cardiac catheterization)
• Post-IV or injection sites

Nursing Considerations

Apply firm pressure for at least 5 minutes at procedure sites (10+ min for anticoagulated patients). Apply ice for first 24 to 48 hours to reduce swelling, then warm compresses. Assess for expanding hematoma (increasing size or pain) and neurovascular compromise (intracranial hematoma). Assess GCS, pupils, BP (Cushing's triad). Post-cardiac cath: monitor for bleeding, assess pulses distal to site.

NCLEX Relevance

Expanding or new hematoma after procedure = red flag. Intracranial hematoma = neurologic emergency.