Physical restraint and subcutaneous hematoma in an anticoagulated patient

A large subcutaneous hematoma extending from the breastbone region to the l eft axillary region and left flank developed in a 86-year-old anticoagulate d man because of repeated microtrauma from a physical restraint used to pre vent his rising from a chair. Physicians, nurses, and physiotherapists shou ld recognize that physical restraints causing pressure on the skin increase hemorrhagic risk in patients who take low molecular weight heparin, Accord ingly, they should systematically check for hemorrhagic complications and a ttempt to limit the use of such devices.