Bleeding Disorders: Diagnosis

Bleeding disorders should always be considered life-threatening. Even the stable patient with a bleeding disorder can decompensate rapidly from massive bleeding or bleeding into a vital organ. Moreover, regardless of the initiating cause, severe uncon- trolled hemorrhage can lead to shock, hypothermia, acidosis, consumption of coagula- tion factors, and hemodilution which in turn result in a bleeding disorder and exacerba- tion of hemorrhage. rapid identification and correction of the underlying and contributing causes of bleeding is paramount.

Bleeding disorders are classified as disorders of primary hemostasis, disorders of sec- ondary hemostasis or disorders of fibrinolysis; and as congenital or acquired. Characteri- zation is an important diagnostic step and will guide appropriate testing and manage- ment.

This presentation will review the causes of bleeding disorders, clinical testing and assessment, and will illustrate a logical, rapid and efficient approach to diagnosis in the emergency setting.