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Emergency Department Care for Patients with Hemophilia and Von Willebrand Disease
- Source :
- The Journal of Emergency Medicine. 39:158-165
- Publication Year :
- 2010
- Publisher :
- Elsevier BV, 2010.
-
Abstract
- Patients with bleeding disorders such as hemophilia A, hemophilia B, and von Willebrand disease (VWD) are routinely treated at home, with their care managed in specialized centers. In emergency situations, these patients often present to their local emergency department (ED), where their management can represent a challenge to the emergency physicians and staff who rarely encounter them. Delays in diagnosis and administration of replacement therapy are the factors most commonly identified as predictive of death. Patients and family members are often very well educated in the disease and its management, which can significantly reduce morbidity and mortality. Children with bleeding disorders confer different challenges to the emergency physician and staff: they may present with no obvious signs of trauma or they may present with bruises consistent with non-accidental injury. All possible causes of bruising/bleeding should be investigated, although treatment should be administered promptly. The initial presentation of a bleeding disorder in the pediatric population is often made in the ED. Treatment of hemophilia A and B requires rapid replacement of the deficient clotting factor, with the desired factor level and dosage dependent on the product used and the hemorrhagic situation encountered. In patients with VWD, the main treatments are desmopressin or intravenous infusion of plasma-derived concentrates containing factor VIII and von Willebrand factor. The aim of this review is to outline some of the issues facing emergency physicians and the options available for the treatment of patients with hemophilia A, hemophilia B, and VWD.
- Subjects :
- congenital, hereditary, and neonatal diseases and abnormalities
Pediatrics
medicine.medical_specialty
Disease
Hemophilia A
Hemophilia B
Hemostatics
Von Willebrand factor
hemic and lymphatic diseases
medicine
Von Willebrand disease
Humans
In patient
Child
Desmopressin
Intensive care medicine
Clotting factor
biology
Coagulants
business.industry
Emergency department
medicine.disease
Recombinant Proteins
von Willebrand Diseases
Emergency Medicine
biology.protein
Emergency Service, Hospital
business
medicine.drug
Pediatric population
Subjects
Details
- ISSN :
- 07364679
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- The Journal of Emergency Medicine
- Accession number :
- edsair.doi.dedup.....2926da04b392d771577a38b46fa00061