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Managing Bleeds¹

When bleeds occur, your best chance of reducing joint damage is to treat the bleed early and aggressively. That's why recognizing the symptoms of a bleed as soon as it begins is the first step in effective treatment.

Symptoms of a bleed: Adults

The earliest symptom of a joint bleed may include:

• A bubbling or tingling feeling in a joint.
• An aura, which is a sort of unusual sensation — when the joint begins to bleed.

Later symptoms of a joint bleed may include:

• Stiffness, pain or swelling in the joint.
• The skin over the joint feels warm.
• The joint is unable to bear any weight.

Symptoms of a bleed: Children

Recognizing a bleed in children can be difficult. Parents should watch for the following nonverbal cues:

• Crankiness or crying.
• Limping or favoring an arm.
• A child who has learned to walk but reverts to crawling.

Responding to a bleed

The most important thing to do when responding to a bleed or a potential bleed is to treat with factor as soon as possible. Because early treatment is better, it's a good idea to keep a supply of factor on hand, as well as phone numbers for your treatment center or healthcare professional.

While the bleed is in progress, you should follow R.I.C.E. to help with pain, reduce swelling and prevent further damage. R.I.C.E. stands for Rest, Ice, Compression, and Elevation.

Rest — Use the joint as little as possible. Depending on which joint is affected and the seriousness of the bleed, you may want to be on bed rest, or use a splint, sling or crutches.

Ice — Put ice on the affected joint to reduce swelling and pain. You can use a bag of ice, a bag of frozen vegetables, or an ice pack product. The usual recommendation is to apply ice for 5 minutes, then wait at least 10 minutes before applying it again.

Compression — Using an elastic bandage, apply pressure around the joint.

Elevation — Hold the joint higher than the rest of body to help blood flow away from the joint, reducing swelling and pain.

Contact your Treatment Center

After your child has been treated with factor and started R.I.C.E., you may want to contact your physician or your treatment center, particularly if you are uncertain about the seriousness of the bleed or about how much factor your child should be taking. Your healthcare professional can help you decide whether any further care is needed.

Tracking bleeds and infusions is an important part of maintaining a healthy lifestyle for people with hemophilia. To learn about an easier way to log bleeds and infusions, visit Advoy.com.

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References

1. Hemophilia in Pictures. World Federation of Hemophilia website. Available at http://www.wfh.org. Accessed August 7, 2008.