A Patient Safety Approach for Imaging-Guided Breast Interventions: Red Rules for Prevention of Hematoma

Abstract

OBJECTIVE: To present the safety program and red rules we use to prevent hematoma complications in imaging-guided breast interventions. METHOD: Patients who underwent breast intervention between January 2011 and January 2013 were included in the study. From the patient records, procedure-related features and hematoma complications were investigated retrospectively. RESULTS: A total of 173 patients had breast intervention. In the records, it was understood that hematoma developed in 3 cases, these were approximately 1.5 cm in diameter, and 2 of them developed after a core biopsy and one the vacuum biopsy. DISCUSSION AND CONCLUSION: A successful interventional procedure not only provides the diagnosis of the diagnosis but also prevents the possible complications. The most important complication in breast interventions is hematoma. In its prevention, some points to be applied before, during and after the procedure may be useful. Before the procedure, bleeding diathesis, drugs should be questioned, and INR and platelet levels should be checked. During the procedure, the biopsy region should be evaluated with Doppler. Interventions should be performed by a non-traumatic manner. The needle should be entered by holding itself, not the handle of the needle. Among the samples, compression can be made to the biopsy region with an ultrasound probe. After the procedures the patient should be turned into a pron position, and passive compression should be performed on the biopsy site with his own body weight for 10 minutes. In mammography, after the intervention, active compression should be made for 5 minutes with the compression plate of the device, and passive compression should be continued as in ultrasonography. A pressure bandage can be applied while closing the biopsy site. As a result, red lines in breast interventions can be determined as investigation of the patient's bleeding diathesis, evaluation of the vascularity of the biopsy region and compression.