RT Book, Section
A1 Bailey, Jessica A.
A1 Mickley, Megan
A2 Tintinalli, Judith E.
A2 Ma, O. John
A2 Yealy, Donald M.
A2 Meckler, Garth D.
A2 Stapczynski, J. Stephan
A2 Cline, David M.
A2 Thomas, Stephen H.
SR Print(0)
ID 1166596155
T1 Hematologic Emergencies in Infants and Children
T2 Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260019933
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1166596155
RD 2024/04/24
AB Bleeding  in  a  child  can  be  a  diagnostic  dilemma,  because  the  causes  range  from  benign  to  serious.  Children  with  mild  bleeding  disorders  may  not  experience  an  episode  of  bleeding  until  faced  with  a  hemostatic  challenge,  such  as  an  interventional  procedure  or  trauma.  On  the  other  hand,  children  without  an  underlying  bleeding  disorder  commonly  present  with  complaints  of  bruising  and  bleeding  such  as  epistaxis  or  menorrhagia.  Red  flags  for  a  potential  bleeding  disorder  include  bleeding  or  bruising  out  of  proportion  to  the  injury,  prolonged  and/or  recurrent  bleeding  (particularly  with  unknown  cause  or  after  a  small  injury  or  procedure),  spontaneous  bruising  or  bleeding,  uncommon  sites  of  bleeding  (joints,  GI)  or  bruising  (proximal  extremities,  trunk),  and  a  family  history  of  a  bleeding  disorder.  Consider  nonaccidental  trauma  in  the  child  with  unusual  bruising  patterns  (see  Chapter  150,  “Child  Abuse  and  Neglect”).  Figure  144-1  provides  a  basic  approach  for  the  initial  ED  assessment  of  a  child  with  bleeding.  The  most  common  bleeding  disorders  presenting  in  childhood  are  discussed  below.