The most common types of bleeding in relation to haemophilia is internal bleeding into the joints or muscles and bleeding may occur without any obvious cause. Repeated or untreated bleeding into joints and muscles can cause permanent damage such as arthritis, chronic pain and joint damage requiring surgery.
Joints and Muscles
For those severely affected, a major problem can be internal bleeding into joints, muscles and soft tissues. All of us damage our muscles in small ways in the activities of everyday life. Most people repair that damage automatically. For the person with a severe bleeding disorder, however, the tiny breaks in the blood vessels in joints and muscles may continue to bleed as a result of normal everyday activity. These bleeds are sometimes described as “spontaneous” because it is impossible to identify a cause.
An ache or irritation in an affected area is usually an indication that a person with haemophilia is getting a bleed. If left untreated pain may become excruciating. In the case of joint bleeding, the blood which has escaped into the joint has a very damaging effect on the surface of that joint. Once a joint becomes damaged then bleeding will occur more frequently resulting in a “target joint”. The majority of bleeds into joints and muscles occur in the lower limbs, with ankles and knees being the worst affected in most people.
Cuts and grazes
When cuts and grazes occur, cover them with a plaster and bandage and apply pressure to them for a few minutes. Deep cuts that may need stitching will need treatment at a haemophilia centre.
Tilt head forward and pinch the bridge of the nose below the bone for 10-20 minutes and/or put an ice-pack on the bridge of the nose for not more than 5 minutes.
Mouth and Tongue Bleeds
These can be hard to control because clots that form are washed away by saliva, or knocked off by the tongue or food. These bleeds usually need treatment by parents or treatment centre but try giving the child an ice cube or ice pop to suck as this may do the trick.
Soft Tissue Bruises
Soft tissue bruises will always occur in people with bleeding disorders. Although these may look serious they usually do not require any treatment. Sometimes if the bruise is increasing in size and causing pain, then factor treatment may be recommended.
Head, Face and Neck Injuries
After a blow to the head, face or neck, sufficient factor must be given immediately to bring the factor level to 100%. All these injuries must be assessed at a treatment centre. If the injury is significant enough a person with a bleeding disorder may need to be admitted to hospital and may require a CT scan to ascertain the extent of bleeding, if any.
Minor Head Injuries
These are injuries that can lead to bruising or even small cuts on the head. These injuries should always be treated either at home or at the treatment centre.
Serious Head Injuries
These result from a severe bang on the head. A head injury is always serious if the person is unconscious. These injuries should be treated as quickly as possible and the patient taken to the nearest haemophilia centre.
Please contact your Haemophilia Treatment Centre if you are concerned about any bleeding episode.