Page 279 - ATP-P 11th Ed

SUBUNGUAL HEMATOMA PROTOCOL

SPECIAL CONSIDERATIONS
None
Signs and Symptoms
1. Pain from the affected nail
2. Purplish-black discoloration under the nail
Management SECTION 2
1. Decompress the nail with a large gauge needle by rotating needle through the nail di-
rectly over the discolored area until the underlying blood has been released and the
pressure is relieved. Make sure that it is introduced into the affected nail with a gentle
but sustained rotating motion.
2. Gentle pressure on the affected nail may help to evacuate more blood.
3. Treat per Pain Management Protocol.
4. If a fracture is suspected, tape the injured finger or toe to an adjacent digit.
5. If fracture is suspected in a setting of a subungual hematoma, give moxifloxacin
®
(Avelox ) 400mg PO qd for 7 days.
Disposition
1. Evacuation should not be required for this injury if the subungual hematoma is
successfully treated.

268 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 269