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Am Fam Physician. 2005;71(5):856

to the editor: I would like to describe the procedure for traumatic subungual hematoma (see accompanying figure), which I have performed in my office. Management is as follows:

(1) Clean wound with alcohol.

(2) Lightly twist the point of an 18- or 21-gauge needle back and forth between index finger and thumb after positioning over the hematoma.

(3) After about one minute, you will note a small amount of blood at the tip of the needle.

(4) Clean the dust and blood from the nail with alcohol and proceed while positioning a heparinized hematocrit tube adjacent to the needlepoint.

(5) Blood will be extracted by capillary action into the tube.

(6) Change tubes, pressure, and angle of the needle to extract as much blood as possible.

This procedure is relatively painless for your patients.

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