Types of Bleeds
This section of The Handbook describes each of the most common types of bleeding. It gives the signs and symptoms of that type of bleeding. There are also tips for preventing bleeding. It is important to talk to your bleeding disorder doctor (hematologist or HTC) before beginning any treatment.
You are not likely to have all the types of bleeding talked about here. Some of them are rare, even in people with severe Hemophilia. All of these bleeds can be treated. Treating right away when you have a bleed means that you will:
- Reduce the chances of having lasting damage.
- Prevent further pain and the need to take medicine for pain.
- Reduce the number of treatments needed.
Remember that a person with a bleeding disorder will not bleed faster than anyone else. The bleeding will just last longer if untreated.
Early treatment of bleeding is ideal for anyone with a bleeding disorder, especially important for people with moderate to severe bleeding disorders. They should follow these rules for early treatment:
- Take factor right away if you have an injury. This is especially important if a similar injury caused a bleed in the past.
- Take factor as soon as you think you are bleeding.
- Take factor as soon as you see or feel any signs of bleeding such as tingling, bubbling, warmth or swelling.
- If you are not sure you are bleeding, take factor anyway.
Please refer to your bleeding disorder doctor or HTC to get the correct dosage and days of treatment for your bleed. Below is a recommendation for treatment that some providers follow.
To help people with Hemophilia determine the right dose for each type of bleed, a desired factor level is provided. This is shown as a percentage (%). The percentages go from 40% to 100%. This page shows you how to figure out how much factor to take to get the right percentage level*. The levels given are the ones that stop bleeding for most of the people most of the time. These levels may not work for everyone. You may need more factor if you are taking it more than an hour after the bleed started. Some people can use less factor to stop a bleed. Your doctor can help you find the factor level that works the best for you.
*For people with VWD, there is a similar dose calculation, which your provider can discuss with you.
It is important to keep a record of when you had a bleed and how you treated it. Some people with bleeding disorders find that they bleed more with certain activities, events, holidays, or vacations. Others tend to bleed when they are nervous or under stress. A treatment record can help you and your doctor learn what things make you bleed more. If you know what to expect, you can be prepared to treat bleeds early. Be sure to write on your treatment calendar when you take other medicines. Some of them can cause you to have more bleeds.
Remember that with bleeds, you may need to go by how you feel instead of what you see. Some of the most serious bleeds are not easily seen. If you are a parent, pay close attention to what your child says about how they feel. Do not forget that symptoms (what you feel) can be caused by problems other than bleeds.
If the bleed, pain or swelling continue to get worse after treatment call your doctor or hospital. A few types of bleeds are dangerous or even life-threatening.
Bleeds are especially dangerous in these parts of the body:
- Head
- Eye
- Throat
- Neck
- Back
- Groin
- Hip
- Abdomen (stomach)
If you get hurt in one of these areas or think you may be bleeding there:
- Take factor
- Get medical help right away.
This chart shows the factor level needed to treat certain bleeds. For each type of bleed, read across to find out how high to raise your factor level if you have Hemophilia A or Hemophilia B. Check with your Hemophilia Treatment Center or doctor to see if these guidelines are right for you.
If you are on non-factor products, then these levels may be different and should be discussed with your Hemophilia Treatment Center.
Hemophilia A (VIII)
|
Type of Bleed |
Desired Factor Level |
| Head | 80% to 100% and call your doctor |
| Throat and neck | 80% to 100% and call your doctor |
| Eye | 80% to 100% and call your doctor |
| Stomach and intestines | 80% to 100% and call your doctor |
| Muscles in the pelvis (iliopsoas) | 80% to 100% and call your doctor |
| Muscles in the arms and legs | 40% to 50% |
| Joint | 40% to 50% |
| Bruises | may not need factor |
| Small cuts and scrapes | may not need factor |
| Nosebleeds | may not need factor |
| Mouth bleeds | may not need factor |
Hemophilia B (IX)
|
Type of Bleed |
Desired Factor Level |
| Head | 80% to 100% and call your doctor |
| Throat and neck | 80% to 100% and call your doctor |
| Eye | 80% to 100% and call your doctor |
| Stomach and intestines | 80% to 100% and call your doctor |
| Muscles in the pelvis (iliopsoas) | 80% to 100% and call your doctor |
| Muscles in the arms and legs | 40% to 50% |
| Joint | 40% to 50% |
| Bruises | may not need factor |
| Small cuts and scrapes | may not need factor |
| Nosebleeds | may not need factor |
| Mouth bleeds | may not need factor |
Important for any type of bleed: Call your doctor if bleeding, pain or swelling lasts longer than you expect.