1. Bleeding Disorders

what is a bleeding disorder?

failure of normal hemostatic mechanisms

how can a bleeding disorder occur?

it can be provoked by trauma or occur spontaneously

what are major causes and risk factors for bleeding disorders?

• platelet deficiency or defects

• inherited or acquired coagulation factor problems

• vasculature defects

• severity and duration of thrombocytopenia • sepsis • increased ICP • liver dysfunction • renal dysfunction • alcohol abuse • dysproteinemia

what can increase platelet count?*

• bone marrow stimulation to increase platelet production

• splenectomy can increase circulating platelets

what are platelets?

cellular components of blood involved in blood coagulation that play an essential role in bleeding

• most in circulation, 20% in spleen

what is the normal platelet count?*

150,000 to 400,000 cells/mm3

when do bleeding symptoms start to occur with thrombocytopenia?*

when the platelet count is 20,000 cells/mm3 or less

what bleeding findings can occur when the platelet count is 20,000 cells/mm3 or less?

• petechiae

• nose bleeding

• gum bleeding

• excessive menstrual bleeding

• excessive bleeding from surgery or dental procedures

when can spontaneous and potentially fatal bleeding occur?*

when the platelet count is 5,000 cells/mm3 or less

when is bleeding risk greater even if the platelet count is only mildly reduced?*

when the thrombocytopenia is medication-induced or disease-related