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Excessive Bleeding after Injection Raises Suspicions

Jul 6, 2015

A man 79 years of age was referred to me to start insulin. As a diabetes educator, I don’t always have a full history and comprehensive labs given to me from the PCP. I met the patient and his family who told me his history, medications, lifestyle, etc…. I instructed him on insulin administration. He did a return demonstration on his abdomen. The site bled more than I’ve ever experienced when teaching someone. I held pressure on the site. It took at least 5 minutes to stop bleeding. The medications he told me he was on did not include any aspirin or other anticoagulants. I asked again to be double sure and also asked about any supplements he may not have mentioned to me. There were none….

It was such an unusual bleed at the site, I reported the incident to his physician. It wasn’t long after that I heard the gentleman was being worked up for and was diagnosed with a rare liver disease.

Lesson Learned:

  • When something so routine seems out of the ordinary, take heed and take action.
  • Action may even just be to report the incident to someone who can take more action.
  • Follow up to see that action was taken. If not, take another route of action.
  • Action includes following up with the patient yourself to see if the problem continues.
  • Never let the unusual and unexpected drop.

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