• Rahul Bhat and Whitney Cabey.
• Department of Emergency Medicine, Georgetown University Hospital/Washington Hospital Center, 110 Irving Street Northwest, Washington, DC 20010, USA. Electronic address: rgbhat77@gmail.com.
• Emerg. Med. Clin. North Am.. 2014 Aug 1;32(3):673-90.

AbstractPatients presenting to the emergency department with acute bleeding and a history of clotting or platelet disorder present a unique challenge to the emergency physician. The severity of bleeding presentation is based on mechanism as well as factor levels: patients with factor levels greater than 5% can respond to most minor hemostatic challenges, whereas those with factor levels less than 1% bleed with minor trauma or even spontaneously. Treatment should be initiated in consultation with the patient's hematologist using medications and specific factor replacement, except in rare, life-threatening, resource-poor situations, when cryoprecipitate or activated prothrombin complex may be considerations. Copyright © 2014 Elsevier Inc. All rights reserved.

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