Journal
HEMATOLOGY-ONCOLOGY CLINICS OF NORTH AMERICA
Volume 31, Issue 6, Pages 1105-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.hoc.2017.08.011
Keywords
Congenital; Bleeding; Hemophilia; von Willebrand; Factor; Coagulopathy; Platelet dysfunction
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Patients presenting to the emergency department with acute bleeding and a history of clotting or platelet disorder present a unique challenge to the emergency physician. The severity of bleeding presentation is based on mechanism as well as factor levels: patients with factor levels greater than 5% can respond to most minor hemostatic challenges, whereas those with factor levels less than 1% bleed with minor trauma or even spontaneously. Treatment should be initiated in consultation with the patient's hematologist using medications and specific factor replacement, except in rare, life-threatening, resource-poor situations, when cryoprecipitate or activated prothrombin complex may be considerations.
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