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Injury Prevention and Safety

Bruise

03/10/2008

Question:

which color bruise is considered to be the worst?

Answer:

Health professionals used to rely on bruise color to estimate how recently an injury occurred. However, it is well known now that bruise color is not at all a reliable measure of how bad a bruise is or when the injury occurred.

Large bruises over the abdomen and pelvis that may signal that serious damage has been done to the organs underlying the bruise. The bruise itself is deceptive because you can't see the underlying damage that is far more serious than the visible discoloration. This can be deadly, especially if organs rich in blood supply such as the liver and spleen are damaged and the person bleeds to death internally.

Of course, bruises over the bone can mean that a hemorrhage occurs under the bony covering called the periosteum and also may lead to a fracture of the bone underneath. These are certainly painful but do not lead to death very often. They can look worse because of the impact of the blood vessels onto the bone as compared to soft tissue bruising over the abdomen. Bruises around the eyes and ears can damage vision and hearing if the force of the injury was significant.

The bottom line is that color is not what is so important. It is much more important what the force of the injury was and what parts of the body are underneath the force of the injury. I hope this answers your question.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University