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Tag Archives: coagulation
Case 92 – summary
Thanks for your help with the cases. This week we have looked at three different scenarios regarding bleeding or bruising presenting in the paediatric population. The cases although different have some common themes: Coagulation testing in paediatrics is challenging for … Continue reading
Posted in Acquired bleeding, Inherited bleeding, Paediatric haematology
Tagged APTT, bleeding, bleeding history, bruising, coagulation, coagulopathy, easy bruising, Ehlers Danlos, Factor assays, factor deficiency, Factor XII, family history, intercranial haemorrhage, neonatal, non-accidental injury, paediatrics, vitamin K
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Case 92 – update part A
Thanks for your help so far An 8 week old baby boy born at 40+2 by Normal vaginal delivery has a CT that confirms a subdural haemorrhage. Results: (With age adjusted reference ranges) FBC – Hb 120 (Low) MCV 120 … Continue reading
Case 92 – the beginning
This week we will be looking at investigation of bleeding and bruising in the paediatric setting with three short cases. Case 1 An 8 week old baby boy born at 40+2 by Normal vaginal delivery presents with a reduced consciousness … Continue reading
Case 74 – summary
Thankyou for your input this week!This week we had a look at a few abnormalities that can be seen on coagulation screens in a pre procedure setting. The first thing to say is there is no replacement for a good … Continue reading
Case 74 – part 3
We have our 3rd and final case of the week! A 40 year old man who has a vasculitis ,who has been requiring plasma exchange, needs to have a new line put in for exchange. The renal team are concerned … Continue reading
Posted in Acquired bleeding, Anticoagulation
Tagged APTT, coagulation, coagulation screen, Heparin, Prolonged APTT, Thrombin time
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Case 74 – part 2
So our second case starts with a phone call from the anaesthetic consultant in the pre op clinic. He has a 20 year old man that needs a wide excision of a suspicious mole on his back. He has been … Continue reading
Case 74 – part 1
Welcome to our new teamhaem cases!This week we will run through some short cases with pre operative coagulation screen abnormalities! Our first patient is a 25 year old male who has been admitted to the surgical assessment unit with abdominal … Continue reading
Posted in Acquired bleeding, Inherited bleeding
Tagged APTT, coagulation, coagulation screen, factor deficiency, Factor XII, Prolonged APTT
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Case 64 – part 2 – summary
The main aim of this case was to remember that the coagulation screen alone is not suitable for ruling out a bleeding disorder. The most common inherited bleeding disorder frequently will have a normal clotting screens. Indiscriminate clotting screens are … Continue reading
Case 64 – part 2b
Further questioning of our pre-operative patient reveals she has easy bruising without trauma and has required cauterisation for epistaxis in the past. She bled after a tooth was removed and had to see the dentist following the procedure due to … Continue reading
Case 64 – part 2a
A 31 year old female is in pre-assessment clinic for an elective laparoscopic cholecystectomy for gallstones. She has no other major medical problems although she does say that she bruises easily after trauma. She also has heavy periods which are managed … Continue reading
Case 64 – part 1 – summary
We started with a 72 year old gentleman who was having an elective pacemaker insertion. He had an isolated prolonged APTT and we have previously used the following flow chart to make a diagnosis: It should be remembered that … Continue reading
Case 64 – part 1c
Our patient has a long APTT and has a haematoma and extensive bruising following pacemaker insertion. He is not on any anticoagulation, but does not have any previous clotting screens to compare to. Given the bleeding history, FFP is administered … Continue reading
Case 64 – part 1b
The patient with abnormal clotting resulst goes ahead with his planned pacemaker insertion. There is no major bleeding during the procedure but afterwards there is a large haematoma around the pocket with extensive bruising. Repeat clotting screen shows: PT … Continue reading
Case 64 – part 1a
This week we’re going to present a series of short cases around clotting results. Hopefully we’ll demonstrate when coagulation screens should be used and also how to interpret basic abnormalities. It most be noted that different labs will use different … Continue reading
Case 58 – summary
We covered a lot of issues this week. Here is a link to the case on Storify: https://storify.com/TeamHaem/case-58-teamhaem-does-dvt Our patient was a 37 year old female with left leg swelling. She had no major medical problems and was on no … Continue reading
Posted in Anticoagulation, Thrombosis
Tagged anticoagulation, coagulation, d-dimer, DVT, Swollen leg, ultrasound, VTE, wells score
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Case 37 part 3 – summary
Our patient was unwell with pneumonia. The results showed an isolated prolonged APTT: PT 14s (11-14s) APTT 48s (33-40s) APTT 50:50 mix 47s Fibrinogen (Clauss) 4.9g/L (1.5-4.5g/L) Thrombin time 16s (15-19s) She was not on any anticoagulation and had no … Continue reading
Case 37 part 3 – update 1
The patient is rather unwell with a community acquired pneumonia and requiring supplemental oxygen and intravenous antibiotics. She is not ‘septic’ with low BP etc. There is no history of bleeding and the coagulation screen 5 years pre knee operation … Continue reading
Case 37 part 3 – the beginning
Welcome back. Case 37 has focused around an abnormal APTT. This is a common finding in the routine coagulation screen. It is important to investigate appropriately to avoid delayed procedures and patient anxiety. The first case had a factor XII … Continue reading
Posted in Inherited bleeding, Thrombosis
Tagged APTT, coagulation, Lupus anticoagulant
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Case 37 part 2 – summary
The key to this mini case was the history. The patient had had numerous previous operations without problems. Therefore inherited bleeding disorder is unlikely. The clotting screen had previously been normal so an acquired problem is what we’re dealing with. … Continue reading
Posted in Anticoagulation, Inherited bleeding
Tagged APTT, coagulation, FFP, Heparin
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Case 37 part 2 – update 1
Here are some results that may help: PT 14s (11-14s) APTT 56s (33-40s) Fibrinogen (Clauss) 6.9g/L (1.5-4.5g/L) Thrombin time 38s (15-19) Questions What has happened here? Please reply to us (@teamhaem) on Twitter and always include #teamhaem to allow others … Continue reading
