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American family physician · Jul 2024
ReviewHematologic Emergencies: Recognition and Initial Management.
- Darrell Edward Jones, Jennifer J Walker, and Alain Michael P Abellada.
- U.S. Army Family Medicine Hospitalist Fellowship at Womack Army Medical Center, Fort Liberty, N.C.
- Am Fam Physician. 2024 Jul 1; 110 (1): 586458-64.
AbstractHematologic emergencies are bleeding or clotting disorders that are hereditary or acquired and must be treated emergently to avoid significant morbidity or mortality. Patients experiencing a hematologic emergency may present with spontaneous bleeding, jaundice, petechiae, or purpura. Initial diagnostic testing should include a complete blood count. Patients who have bleeding associated with a hereditary disorder should receive clotting factor replacement before diagnostic testing. Acute chest syndrome is an uncommon but serious complication of sickle cell disease. Hemolysis caused by autoimmune disorders or iatrogenic errors from blood product transfusions has a distinct clinical presentation and requires immediate action. Severe thrombocytopenia presenting as immune or thrombotic thrombocytopenic purpura should be differentiated and treated appropriately. Disseminated intravascular coagulation and trauma coagulopathy are sometimes confused with each other, but both can cause serious injury and require unique treatments. Primary care physicians should promptly recognize patients who require emergent referral to a hematologic specialist.
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