ED Clinical Pathway for Evaluation/Treatment of Children
with Hemophilia and CHI
Child with Hemophilia CHI
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Stable Patient
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Feiba or Novo-Seven used
Identifies patients with inhibitor
No/Inadequate home correction
Adequate correction
Immediate MD Order
Non-contrast head CT
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Immediate MD Order
Immediate MD Order
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Complete history, physical
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Hematology consultation
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Abnormal CT
Normal CT/non-focal exam
Persistent symptoms
Significant mechanism
(LOC, sz/ fall > 3 ft., etc.)
Inhibitor
Normal head CT
Asymptomatic
Mild mechanism
Ability of family to
do f/u care
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Neurosurg Consult Admit PICU
Admit Heme service
Discharge home
Posted : August 2005
Revised : October 2011, May 2012
Authors : J. Lavelle, MD, R. Butler, RN, C. Witmer, MD