Direct pressure for 5 minutes reduces ecchymosis after venipuncture in older anticoagulated patients

This randomized controlled trial evaluated the effect of applying 20 N of direct pressure after venipuncture on ecchymosis development in 164 older patients (mean age 76.26 years, 50% women) hospitalized at a geriatric clinic. All participants were using oral or subcutaneous anticoagulants (56.1% used subcutaneous anticoagulants) and did not have coagulopathy. The intervention groups applied pressure for 1, 3, or 5 minutes after blood collection, while the control group's pressure duration was not specified in the abstract.

The primary outcome was the frequency and size of ecchymoses at 24, 48, and 72 hours. Statistically significant differences were found between the intervention and control groups at all time points (24 hours: χ²=30.792, p < 0.001; 48 hours: χ²=28.698, p = 0.001; 72 hours: χ²=26.429, p = 0.002). The incidence of ecchymoses ≥1 cm² in the control group was 14% at all three time points, which was significantly higher than in all intervention groups (p < 0.05). However, the abstract does not report the specific incidence rates or effect sizes for the 1, 3, and 5-minute intervention groups.

Safety and tolerability data were not reported. Key limitations include the lack of reported absolute event rates for the intervention groups and the unspecified pressure duration for the control group. The abstract also does not report which specific intervention duration (1, 3, or 5 minutes) was most effective, though the conclusion mentions 5 minutes. For practice, applying pressure for 5 minutes appears to be a simple, non-invasive method to reduce ecchymosis in older anticoagulated patients, but clinicians should note the incomplete reporting of comparative efficacy between the different pressure durations.