Caring for children with bleeding disorders in a community program 20140430 Bleeding Disorders 1 Blood vessel is injured amp bleeding starts 2 Blood vessel tightens 3 Platelets make a plug ID: 225737
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Slide1
Bleeding Disorders
Caring for children with bleeding disorders in a community program
2014-04-30Slide2
Bleeding Disorders
1. Blood vessel is injured & bleeding starts.
2. Blood vessel tightens.
3. Platelets make a plug.
4. Clotting factors form a clot.
With bleeding disorders, blood does not clot normally
Bleeding does
not
occur faster or more profusely Slide3
Hemophilia
Clotting factor is missing or low
Factor VIII – Hemophilia A
Factor IX – Hemophilia B
3 levels of severity
Mild
Moderate
Severe
InheritedSlide4
Von Willebrand Disease
Problem with the Von Willebrand Factor (VWF) clotting factor
Most common inherited bleeding disorder
3 types
Type 1 - most common form, mild
Type 2 VWD – moderate symptoms
Type 3 VWD - rare, most severe
InheritedSlide5
Idiopathic Thrombocytopenic Purpura (ITP)
Involves immune system
Antibody coats the platelets and causes them to be destroyed
Cause is unknown
Majority of ITP cases in children are temporarySlide6
Treatment
Basic treatment is to stop or prevent bleeding
Medical treatment is not always necessary for minor bleeds
Joint & muscle bleeds require treatment
Types of treatment
Factor replacement therapy
OtherSlide7
Precautions
Restrict activity after injury
Contact sports may be restricted
Do not useAspirin
non-steroidal anti-inflammatory drugs
blood thinners
MedicAlert® identification is recommendedSlide8
Surface cuts
Put on protective gloves.
Clean skin.Apply firm continuous pressure until bleeding stops.
Apply a band-aid or dressing.Encourage ice.Slide9
Nosebleeds
Put on protective gloves.
Encourage the child to gently blow his/her nose to remove mucous and unstable clots.
Position the child sitting with head slightly forward.
Apply firm continuous pressure for a minimum of 10 minutes or until bleeding stops. Use a cold cloth if possible.
Once bleeding has stopped, encourage the child to NOT blow his/her nose again for as long as possible (at least 1-2 hours)Slide10
Mouth Bleeds
Put on protective gloves.
Apply firm continuous pressure ( when applicable) until bleeding stops. Use a cold cloth if possible.Encourage popsicles or ice.Slide11
Surface cuts
Nose bleeds
Mouth bleeds
Call parent/guardian if bleeding does not stop after 20 minutes.
If unable to reach parent/guardian or emergency contact, call 911/EMS.
Provide medical personnel with copy of FactorFirst card, if available. Slide12
Bruising
Notice must be paid to the child who expresses ongoing pain at a bruised site.
Notify parent/guardian if a bruise is increasing in size. It may be helpful to mark the outline of the bruised area with a pen.
Slide13
Muscle & Joint Bleeds
Child may be reluctant to use limb
Muscle or joint may feel tightSwelling
Hot to touchPainSlide14
Joint and Muscle Bleeds
Have the child rest. Keep the
child still to avoid further
injury.2. Apply ice to injury. Do not
leave it longer than 20
minutes.
3. Elevate the injury body part.
4. Contact parent/guardian.
5. If unable to contact
parent/guardian or emergency contact after 15 minutes, call 911/EMS.Provide medical personnel with copy of FactorFirst card, if available.Slide15
Head Injury
Loss of consciousness
DrowsinessDizziness
Irritable
Confused
Nausea and/or vomiting
Dilated or unequal pupils
Headache
Unsteady gait
Injury to eye or surrounding areaPain
Swelling
Life-threatening BleedsSlide16
Neck injury
Pain in neck or throat
SwellingDifficulty swallowing Difficulty breathing
Chest injury
Pain in chest
Difficulty breathing
Coughing up blood
Pale skin
Lack of energyAbdominal injury Pain in abdomen or lower backNausea or vomiting
Blood in urine
Black or bloody stool
Life-threatening BleedsSlide17
Life-threatening Bleeds
If a child has a significant injury to the head, eye, neck, chest or abdomen (with or without signs)
Call 911/EMS.
Notify parent/guardian.
Provide medical personnel with copy of Factor First card, if available. Slide18
Child specific information
Type of bleeding disorder
Precautions/restrictions, if any
Health Care Plans are
located in child file and binder