Recognition and Management of Hemophilia Emergencies

Hemophilia is a congenital bleeding disorder characterized by episodic hemorrhages that can be spontaneous or trauma related and can pose challenges in the emergency department both in diagnosis and management. Timely infusions of hemostatic clotting factors can control bleeding in most circumstances and significantly minimize sequelae. Hemorrhages in some anatomical areas such as the central nervous system, within the abdomen, or into restricted spaces in extremities require a high index of suspicion for early detection. Patients with hemophilia with inhibitors against specific clotting factors can be particularly challenging to treat. Patients with acquired hemophilia can present with severe spontaneous bleeding. Prompt correction of factor deficiencies by infusing an appropriately dosed replacement product is fundamental to effective emergency hemophilia management.