Following the news photos in various media about the “bruises” on the right hand of Queen Elizabeth II, which appeared in the portraits taken with the Prime Minister of England (Liz Truss) on Tuesday, September 6, 2022, and comments from Dr. Deb Cohen-Jones, a General Practitioner in Perth, Western Australia suggesting it’s a sign that the “queen” was nearing her end.
Royal Thai Air Force Marshal (special) Dr. Paisarn Jamnarnpitak, an advisor to the director of Bangkok Hospital, chairman of the medical committee of the Football Association of Thailand under royal patronage, and host of the radio program “Health Road” or “Path to Wellness”, wishes to clarify and provide accurate medical information to the Thai people regarding the dark greenish-black bruises on the skin at the back of Queen Elizabeth II’s right hand.
The cause of these bruises in the general populace, including medical personnel who work in hospitals or clinics, is quite common among patients who require intravenous fluids (saline) or injections, and even from drawing blood from veins on the back of the hand. Especially in elderly individuals whose veins may be fragile, using a needle to draw blood for tests, or to leave the needle in a vein for injections or administering saline over extended periods, can result in this condition in three circumstances:
- Blood seeps out from the vein into the surrounding subcutaneous tissue while the needle is in place or after it has been removed, but not enough pressure was applied to the puncture site with sterile cotton for an adequate time. This can be true for ordinary people who do not have a history of bleeding disorders or the elderly, especially if they are taking blood-thinning medication which improves blood circulation. After removing the needle, the blood may not stop as quickly as it would for others, thus pressure must be applied with clean cotton for enough time to prevent bleeding into the subcutaneous tissue.
- The needle might move out of the vein, leading to more significant bleeding into the subcutaneous tissue.
- During intravenous fluid administration, the patient might move their wrist, or there might be some pulling action, causing the connection between the needle and the IV line to come apart, leading to fresh blood flowing out from the needle still in the vein. This issue, if not promptly addressed, like during nighttime in a patient’s room, could result in a significant amount of blood not flowing into subcutaneous tissue.
After blood has seeped into the surrounding tissue near the vein and into the subcutaneous tissue at the back of the hand, which is not too deep from the skin surface, it may initially appear as a reddish-purple color known as a “hematoma”. But as time goes on, the blood that seeped out contains red blood cells that rupture and hemoglobin (which includes iron) spreads out with the blood under the skin, which later changes to a “dark purple” color. This is similar to boxers or ordinary people who sustain a punch to the eyebrow or eye socket area that might lead to swelling around the eyes, eventually turning into a dark color, revealing a similar reaction.
What should be done is to apply sufficient pressure with clean cotton after puncturing or injecting with a needle into a vein. The dark greenish-black bruises on the skin will heal by accelerating the absorption of substances back into the body. Thus, soaking the hand in warm water to expand the blood vessels and increase blood flow to the area will speed up the absorption of the coloring, making it disappear quicker. In some cases, doctors may prescribe topical or massage medications to speed up absorption back into the body, but typically, if the area is not too large, the condition will heal on its own or just soaking in warm water is sufficient.
In cases where it’s suggested that dark greenish-black bruises on the skin are a warning sign of imminent death, I would like to provide a general comment first that such bruises are commonly and frequently seen in patients who seek hospital services and have had needles inserted into their veins, especially in the elderly. Therefore, based on the news and news photos of Queen Elizabeth II at the time of her greeting the new female Prime Minister standing elegantly and smiling, it would not be accurate to conclude that Queen Elizabeth II was near death solely based on the dark bruises on her hand.
As for the queen passing away two days later, there could have been many other factors that could have contributed to this. In medical terms, for an elderly person around 96 years old, certain conditions can lead to death in a short time. And the fact that she had received medical treatment, whether it was blood drawing or receiving fluids or saline, allowing the public to see the “bruises” on her hand simply indicates that she had been unwell to some extent. Lack of complete and accurate information and quick conclusions could lead to public confusion.
