In an August review article, physicians from the Tulane University School of Medicine (TUSM) outlined some of the challenges and treatment options for emergency room (ER) staff when dealing with patients with bleeding disorders. The lead author of the article was Tammuella Singleton, MD, Department of Medicine, TUSM, New Orleans, LA.

The authors explain that because most patients with hemophilia A or B or von Willebrand disease (VWD) self-treat with clotting factor or another therapy, and receive comprehensive care at a hemophilia treatment center, many ER departments have little experience with them and may inadvertently mismanage treatment. For instance, when a child is admitted with bruises not related to trauma the ER doctors and other staff may be more concerned with the cause of the bruising than providing immediate treatment. In addition, undiagnosed children often first present with symptoms at the ER, prompting staff to order tests before treating. Such scenarios can cause potentially critical delays in treatment. Singleton and colleagues underscored the importance of timely assessment and treatment.

The article, “Emergency Department Care for Patients with Hemophilia and von Willebrand Disease,” was published in the August 2010 issue of The Journal of Emergency Medicine.