Recognising a bleed

Bleed incidents will depend on the severity of the haemophilia. Bleeds can either occur in a child’s muscles or in their joints.

Some important things to consider when a bleed incident occurs:

  • Treat the bleed immediately ‑ Depending on the severity of the patient’s condition, bleeding episodes may vary in in frequency. When a bleed does happen, it is essential to spot the symptoms as early as possible so that appropriate treatment can begin.
  • Some bleeds may be more serious than others ‑ Common bleed incidents such as bruises, nose‑bleeds, mouth bleeds (caused by the loss of a tooth for example) should not require emergency medical attention, but will require observation and consultation with the parent of the child or their Haemophilia treatment provider.
  • Some types of bleeds should be treated as an emergency ‑ There are five main episodes of bleeding that will require emergency medical treatment as they could be potentially life‑threatening for the patient. Intracranial (head) bleeds, ocular (eye) bleeds, bleeding at the neck or throat area, abdominal bleeding and kidney or bladder bleeds. In the event of any of the above incidents, it is essential that the situation is treated as an emergency and emergency‑trained medical staff are contacted immediately.

Joint bleeds

Approximately 85% of bleeds in haemophilia are joint bleeds. The most frequent sites of bleeding are the knees, elbows and ankles. With the aid of physiotherapy and supervised exercise, the joint should be able to recover its range of motion, muscle strength and normal appearance.

Early symptoms of a joint bleed include:

  • 1

    Pain in the joint

  • 2

    Tingling in the joint

  • 3

    Difficulty using a joint (reduced movement, unable to weight bear)

  • 4

    Warmth in the joint area

  • 5

    Swelling

Muscle bleeds

Symptoms of a muscle bleed include:

  • 1

    Difficulty moving an arm or leg

  • 2

    Pain

  • 3

    Difficulty using an arm or leg

  • 4

    Warmth in the muscle

  • 5

    Redness

  • 6

    Bruising

  • 7

    Swelling

  • 8

    When touched, the muscle feels tense or tight even though it is at rest

  • 9

    Numbness or tingling (seek assessment if there is a lot of numbness)

  • 10

    Veins appear larger than normal

  • 11

    In severe cases, skin may change colour or go blue

Treating a bleed

Whether the bleed is in the muscle or joint, it should be treated in the following way:

  • Factor replacement therapy
  • PRICE (Protect the joint, Rest the joint, Ice the joint, Compress ‑ add supporting pressure to the joint, Elevate the joint)
  • Support aids such as crutches or a sling may be required if your injury is severe
  • Physiotherapy