Coags
Only helpful in making the diagnosis; once established unlikely to yield new information
PT - normal
PTT - abnormal (unless mild<unk> 
PTT s/p factor - should correct to normal
Factor VIII assay
Only helpful in making the diagnosis; once established unlikely to yield new information
PT - normal
PTT - abnormal (unless mild<unk> 
PTT s/p factor - should correct to normal
Head CT
If headache, altered mental status, blunt head injury
MRI is preferred to CT if available (better visualization of posterior fossa)
CT A/P
Back, thigh, groin, or abdominal pain
If LP required
replete factor before attempting
If headache, altered mental status, blunt head injury
MRI is preferred to CT if available (better visualization of posterior fossa)
Back, thigh, groin, or abdominal pain
replete factor before attempting
Pain in soft tissue is bleeding until proven otherwise
Paresthesias in legs - consider retroperitoneal bleed
Flexion contracture at the hip- iliopsoas bleed
Easy bruising or bleeding out of proportion to the history of trauma
Recurrent bleeding into joints and muscles
Arthrocentesis not indicated
Prolonged PTT; normal PT
Arthrocentesis not indicated
Consider before treatment (for heme to follow)
Normal: 50-150%
Mild: >5% (usually an insult causes bleeding)
Moderate: 1-5% (usually an insult causes bleeding)
Severe: <1% (spontaneous bleeding not uncommon, multiple bleeding episodes/month)
Hemophilia
Too few
Von Willebrand disease
Thrombocytopenia
Factor V Leiden
Nonfunctional
Hereditary hemorrhagic telangiectasia
Aspirin