Investigation of Possible underlying Bleeding Disorder

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

  • Relevant investigations, including previous results to assess temporal pattern. However more importantly please provide:
    • Bleeding history
    • Family history

Tests

  • Consider  von-Willebrand Disease testing, Haemophilia testing or a general screening test for heamostatic defects (e.g. PFA-100) may be useful
  • Consider lupus anticoagulant serological testing *

Interim/GP management

To refer a patient with this condition, please see the Haematology clinic page for the full referral process and templates.

  • * Please note: a lupus inhibitor will cause isolated prolongation of the APTT and is associated with thrombosis rather than bleeding. Mixing studies and lupus anticoagulant serological tests may be appropriate
  • NB: The yield of investigation of "easy bruising" with standard coagulation studies is relatively low and historical details are more important

For more information please see the Tasmanian Health Pathways website.

Emergency

Blood film suggestive of thrombotic thrombocytopenic purpura (TTP/HUS).

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

Urgent Referrals generally need to be seen in the next one to two weeks

Please discuss these with the Haematology Registrar/Haematologist on call via switchboard on 6166 8308

Semi-urgent:

Triaged by medical staff and generally seen in the next six to eight weeks

Routine:

Triaged by medical staff and given the next available appointment