Bleeding Disorders

Type

Definition

Bruise (ecchymosis)

•  Accumulation of blood under the skin that can range from purple-blue to green-yellow color
•  Significant if > 5 visible bruises

Petechiae

•  Flat, red, < 2 mm diameter areas of skin bleeding
•  Not blanchable or palpable
•  Usually in dependent areas of body (eg, lower legs, sacrum)

Purpura

•  Consists of coalescing petechiae
•  Typically palpable

Hematoma

•  Collection of blood in extravascular space

Bleeding challenge

•  Event which typically causes bleeding in normal individuals
  •  Childbirth
  •  Dental cleaning
  •  Surgery
  •  Trauma

Major bleeding

•  Bleeding causing death or critical organ injury

Primary and secondary hemostasis

•  Primary
  •  Defect typically causes petechiae or mucocutaneous bleeding
  •  Initial steps in forming clot
•  Secondary
  •  Defect usually causes joint bleeding or deep tissue hematomas
  •  Fibrin-based clot formation