Paediatric Palliative Care Guidelines
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Edition/Revision: 1.0
Archived

Catastrophic haemorrhage - Archived

Pathophysiology
  • Rare complication of tumours close to or eroding through a major vessel.
  • Greatly feared by families and patients.
  • In reality very rare.
Signs and symptoms
  • May complicate lymphopoietic conditions such as leukaemia in which platelet numbers and function are both reduced.
  • Often preceded by oozing, epistaxis or haemoptysis.
  • Correlation of platelet numbers with risk of haemorrhage is poor, and platelet numbers alone should not be an indication for transfusion.
Management
  • Be aware of the possibility of haemorrhage and anticipate it.
  • Platelet transfusions, tranexamic acid, etamsylate to optimise clotting.
  • Soften impact by discussion with family, and provision of green towels against which blood is less obvious should haemorrhage occur.
  • Arrange for parenteral quick acting anxiolytic such as Midazolam, and analgesics such as diamorphine to be by the patient’s bedside in case haemorrhage should occur.
Edition/Revision: 1.0
Created 18 Jul 2013 - Archived
Validated 19 Jul 2013 by Ian Back
Last modified 31 Mar 2020
Sat 04 Apr 2020 07:01:59 GMT +0100 (DST)
Last modified 31 Mar 2020