Evidence-Based Emergent Management Of Bleeding Disorders

Children with both congenital (eg, hemophilia or von Willebrand disease) and acquired (eg, immune thrombocytopenia [ITP]) bleeding disorders frequently present to the emergency department (ED) with a wide variety of bleeding-related problems ranging from petechiae to intracranial hemorrhage (ICH). In many instances, such as hemophilia or von Willebrand disease, the bleeding disorder has been previously diagnosed because of an abnormal family history or bleeding in infancy. However, in other instances, a patient may present with abnormal bleeding symptoms (such as a patient with ITP), and it is the role of the emergency clinician to facilitate the diagnosis and initiate therapy. This Pediatric Emergency Medicine Practice article provides up-todate guidelines and an evidence-based review of the most common bleeding disorders and management of specific bleeding emergen cies in the ED.