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Hemophilia with Head Trauma Clinical Pathway, Emergency Department – ED Team Assessment

Hemophilia with Head Trauma Clinical Pathway — Emergency Department

ED Team Assessment

Immediate Interventions

Factor Correction or Bypassing Agent
  • 100% brand specific factor correction
  • or
  • Bypassing agent
    • NovoSeven 90 mcg/kg, repeat every 2 hrs until hemostasis achieved
    • or
    • FEIBA 75 units/kg
    • Not to exceed 200 units/kg/day
    • Do not give if on emicizumab (Hemlibra)
  • If available, use child's home supply
  • Review problem list for dosing
Imaging
  • Non-contrast head CT
  • Complete factor correction or bypassing agent before imaging

History and Physical

History
  • Details of Bleeding Disorder
    • Type of bleeding disorder
    • Severity
    • Presence of inhibitors
    • Treatment prophylaxis with factor or emicizumab
    • Factor product
  • Details of Injury
    • Time
    • Mechanism
    • Initial manifestations
    • Neurologic symptoms
  • Interventions Completed
    • Time factor or bypassing agent given at home
    • Dose calculation of factor if given at home
Physical
  • Mental status, VS
  • Evidence of head and neck trauma
  • Neurologic exam

 

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