Treating Bleeds

All bleed treatment plans should be developed with your doctor, nurse, or hemophilia care team.4

For people with inhibitors, your doctor, nurse, or hemophilia care team should also be alerted about all bleeds — no matter where the bleed is located. Let them know what is being done to manage the bleed and follow any guidance they provide.4,11

General Treatment Guidelines

These are general guidelines for treating bleeds that are not life threatening. These guidelines cannot take the place of professional guidance. Develop a plan for treating bleeds with your doctor, nurse, or hemophilia care team and follow their advice if a bleed happens.4

  • Treat early. You may recognize early signs of bleeding as tingling, numbness, or an aura — an indescribable sense that a bleed is happening.4

    This can happen even before physical signs of a bleed are seen. So trust this sense, because treatment at this stage can help stop bleeding earlier — and result in less tissue and joint damage.4
  • Treat completely. Controlling the bleed is the main goal.4 But treatment doesn't stop there.

    Once you and your doctor, nurse, or hemophilia care team are confident the bleed has been controlled, move and exercise the joint or area. Use the plan you developed with your physical therapist. Returning mobility to the area is important.4,7

    Physical therapy is important for two reasons: it conditions the body to help prevent bleeds and it improves recovery.4,7

    Orthopedic devices can provide support and make movements easier, so they can be useful to ease stress on muscles and joints.4,14
  • Prepare for emergencies. Bleeds do not always happen at home. You should always carry easily accessible identification that clearly states your diagnosis, inhibitor status, type of medications used, and the contact information for your doctor, nurse, or hemophilia care team.4

    This will help the doctors in the emergency department act quickly and effectively.4 If you will be traveling, our travel tips will help you to get ready for the road.

Always talk to your doctor, nurse, or hemophilia care team if you feel pain in your joints.3

What to Do When You Have a Bleed

Basic first aid procedures apply to people with hemophilia, just like everyone else. Bleeds in patients with inhibitors should always be treated under the guidance of your doctor, nurse, or hemophilia care team.4

RICE (rest, ice, compression, and elevation) is an important treatment strategy to remember when it comes to managing muscle and joint bleeds. It can help the bleeding stop faster. It may also reduce the amount of clotting factor needed.4,7

The injury must be completely rested. Ice limits the damage and reduces swelling. Compression limits the swelling and may lead to a quicker recovery. Raise the injured area to limit the amount of blood going into the area, prop it up with a few pillows. Elevating will also help to reduce swelling.
Rest. Give the injury time to completely heal.
Ice. Ice reduces pain and swelling. It also limits damage from the bleed.

The best method is to crush ice in a damp towel and place this over the injured area for 10—15 minutes. Cold packs and ice packs can be useful. Do not put ice directly onto your skin. If you don't have anything else handy, wrap a bag of frozen vegetables or some ice cubes in a towel and apply it to the area. Ice should be applied for 20 minutes, every four to six hours, until swelling and pain decrease.
Compression. Bleeding from cuts will stop more quickly if direct pressure is applied. Compression limits the swelling and may lead to a quicker recovery. Compression may be gentle pressure on the injury, or light bandaging.
Elevation. Raise the injured area to limit the amount of blood going into the area (prop it up with a few pillows). Elevating will also help reduce swelling.

When to Seek Emergency Care

Emergency medical care should be sought if you12:

  • Have a head, neck, or abdominal bleed (whether or not an injury has occurred)
  • Have an uncontrollable nosebleed (more than 30 minutes)
  • Pass blood in the stool or vomit blood
  • Have a lack of sensation in an arm or leg
  • Have had an accident with trauma
  • Experience any unusual bleeding, such as in the groin
  • Experience a bleed and are unable to access a vein or are not on home infusion

Learn about Emergency Care >>

Take Care to Avoid

Bleeds can be painful. But, in managing that pain, it is extremely important to avoid taking any aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) — like ibuprofen — or any medications containing ASA (acetylsalicylic acid) while bleeding occurs. Such pain medications might cause bleeding to last longer, so they are best avoided.11,13,15

Talk to your doctor, nurse, or hemophilia care team if you feel pain in your joints.3