Apply firm pressure for 10 minutes after removing an IV in patients on anticoagulants

If you’ve ever watched a clinical skills video and seen someone remove an IV, you know the moment isn’t as simple as “take it out and move on.” There’s a crucial, quiet step that makes all the difference, especially when a patient is on anticoagulant therapy. That step is not flashy. It’s steady, deliberate, and incredibly effective: apply firm pressure to the IV site with sterile gauze for 10 minutes.

Here’s the thing you’ll want to remember: anticoagulants slow down the blood’s ability to clot. That means a quick tug on the IV doesn’t just end with a tiny ooze—it can become a bigger bleed or a hematoma if you’re not careful. The 10-minute pressure acts like a calm, mechanical brake on the moment when the cannula comes out. It helps the vessel constrict and gives the blood a chance to clot where the IV line used to be. It’s a small ritual with a big payoff in terms of safety and comfort for the patient.

A quick primer on why this matters

• Anticoagulants aren’t just about “no blood clots.” They tilt the balance toward bleeding. Even a routine IV removal can trigger a minor bleed that, in a patient on anticoagulants, might take a bit longer to stop.

• The goal is hemostasis—the patient’s normal process to stop bleeding. Pressing firmly with sterile gauze helps that process by physically compressing the puncture site and promoting clot formation.

• The 10-minute duration isn’t arbitrary. It’s long enough to give the vessel time to constrict and for the initial clot to form, reducing the risk of post-removal bleeding, hematoma, or oozing that could alarm the patient or require additional intervention.

What that 10-minute technique looks like in practice

• Gather a small, clean kit: sterile gauze, clean gloves, a bandage or dressing, and, if available, a small amount of tape to secure the dressing after you’re done.

• Remove the IV cannula as you normally would, then immediately place the gauze over the insertion site.

• Apply firm, steady pressure. You’re not just holding the gauze on top; you’re pressing in a way that occludes the vessel. Think of it as giving the vessel a little moment to close up.

• Keep the pressure continuous for the full 10 minutes. Avoid picking at the site, lifting the gauze to peek, or removing the dressing early. The aim is uninterrupted compression so the clot can form.

• After 10 minutes, assess the site. If there’s still active bleeding, maintain pressure a bit longer and reassess. If it doesn’t settle, or if you notice rapid swelling, severe pain, or a growing hematoma, alert a clinician promptly.

• If the site looks stable, apply a clean, dry dressing or a small adhesive bandage. Tell the patient to avoid heavy lifting or strenuous arm movement for a short period, especially if they’re on anticoagulants.

• Document what you did and when. A quick note about the ten-minute compression helps the care team stay aligned and keeps everyone informed.

What to watch for after you’ve finished the 10-minute pressure

• Bleeding that returns after you remove the gauze. Sometimes a little ooze can show up once you re-check, but it shouldn’t persist.

• Swelling, warmth, or redness around the site. A developing hematoma is more than just a cosmetic concern; it can be uncomfortable and may require monitoring.

• Severe or increasing pain. If pain is escalating rather than easing, that’s a cue to pause and seek guidance.

• Any sign of infection in the days after the removal. While the IV site is a small wound, it deserves the usual care you give any skin break: keep it clean, dry, and observe for redness or discharge.

Practical tips that make this routine second nature

• Use a clean, calm approach. Your tone and demeanor matter; a steady, reassuring presence helps ease a patient who’s already worried about bleeding.

• Keep the area clean and dry. If the gauze becomes damp or soiled, replace it with fresh sterile gauze and reapply pressure as needed.

• Avoid additional manipulation. Don’t rub the site, don’t massage it, and don’t wrap it tightly right away. Let the gauze do the work for those ten minutes.

• Consider the patient’s medication profile. If a patient recently started or increased anticoagulants, the care team may want closer observation after removal. Know who to call if anything seems off.

• Teach a simple takeaway for patients. A short, clear message like, “If you see bleeding after you’re home, apply pressure with a clean cloth and contact the nurse or doctor if it doesn’t stop within a few minutes” travels far.

A broader view: it’s not just about the moment of removal

While the ten-minute rule is focused on the site, the bigger picture is patient safety in anticoagulated clients. These patients are at higher risk for bleeding with procedures that many of us do without thinking twice. Understanding why a step that seems minor matters can transform how you approach clinical tasks overall.

• Hemostasis isn’t just a medical term; it’s a process you support. By applying firm pressure, you’re facilitating a natural healing response and reducing complication risk.

• The principle extends to other venous access procedures. Whether you’re removing a peripheral line, changing dressings, or performing a minor palpation near a site of anticoagulation, gentle, deliberate technique matters.

• Documentation and communication are part of the care you provide. A quick note about the site condition after removal helps the team coordinate follow-up, pain control, or further imaging if needed.

A few additional notes you’ll appreciate in real-life settings

• Different anticoagulants, different nuances. Warfarin, DOACs, heparin—each has its own management considerations. Regardless of the agent, the fundamental action remains—control bleeding at the puncture site.

• Patient education is part of your care. A calm, clear explanation about why you’re applying pressure for ten minutes can reassure the person and reduce anxiety.

• Equipment matters. Clean gauze, a proper dressing, and leakage-free tape aren’t flashy, but they prevent a cascade of little problems that can escalate quickly in a busy ward.

Relatable tangents that still circle back

You know that moment when you’re quiet with a patient after a medical procedure, and you realize how much trust is involved? The patient trusts you to handle a fragile moment with competence. The ten-minute compression is a tiny ritual, but it reinforces that trust. It’s the kind of thing you remember when a shift gets hectic—the steps you take to keep someone safe are simple, repeatable, and powerful.

And if you’re the one caring for a family member, you’ve probably noticed how your calm, methodical approach translates to their comfort too. The same ten-minute rule applies, and explaining it in plain terms can demystify the process for them as well.

A concise takeaway for your clinical toolkit

• After removing an IV in a patient on anticoagulants, apply firm pressure with sterile gauze for 10 minutes.

• Keep the pressure steady, monitor for continued bleeding, and dress the site when stable.

• Watch for signs of hematoma, infection, or persistent pain, and escalate if needed.

• Document the action and communicate any concerns to the next shift or supervising clinician.

• Remember the bigger picture: this small step helps prevent a bigger problem and supports safe, compassionate care.

If you’re exploring ATI Skills Modules 3.0 – Safety Videos, you’ll find a consistent thread here: patient safety is built on simple, reliable techniques you can perform with confidence. The routine may be mundane, but its impact isn’t. In healthcare, the difference between a smooth recovery and a minor setback often hinges on acts like these—quietly precise, practically perfect, and deeply human.

So the next time you’re removing an IV from a patient who’s on anticoagulants, you’ll have this in your toolkit: a firm, steady 10-minute press with clean gauze, followed by a clean dressing and a quick, clear check-in. It’s one of those small steps you’ll likely repeat many times, and each time it helps ensure safety, comfort, and trust. And that’s something worth getting right, every single shift.