lab - bleeding time Flashcards
purpose of bleeding time
assesses plt function and ability of the body to produce clot after trauma
3 methods in bleeding time
duke’s
ivy
template
this method has standardized incision size
template method
we are not conducting plt count if the patient’s plt is ___
<75,000 / ul
principle of test
the use of sterile lancet, puncture in earlobe or forearm. Timer starts once the puncture starts and blot it every 30 seconds
DUKE’S METHOD
- Obtain a piece if filter paper and stopwatch.
- Moisten a piece of cotton with 70% alcohol or povidone iodine and thoroughly cleanse the patient’s middle or ring finger.
- Allow the skin to air dry.
To avoid hemolysis and interfering of esults - Make a puncture wound 2-4 mm deep in the earlobe or finger with a disposable blood lancet.
- Start the stopwatch immediately.
- Be careful not to touch the puncture site. Blot the paper every 30 seconds, until the bleeding stops.
- Record the bleeding time.
how deep is the puncture in Duke’s method
2-4 mm deep
ref range of duke
1-3 mns
advantage of duke’s method
easy to do and convenient (no need of a sphygmomanometer)
ref range of modified Ivy’s method
3-6 mns
disadvantage of duke’s
inconsistent puncture site,
temperature
outdated
ref range (borderline) of modified Ivy’s method
6-11 mns
should be the blood flow more than 15
minutes. Discontinue the test and report
the test as “________
greater than 15 minutes
area we prick for modified Ivy
volar surface of the arm
pressure of sphymomanometer
40 mmhg
dis of ivy
invasive
time consuming
increase risk of infection
advantage of modified Ivy’s
standardized test because of the use of mmhg
sensitive compared to duke
prolonged bleeding time
thrombocytopenia
glanzmann disorder
von Willebrand disease
vasculitis
plt function disorder
uremia
scurvy disease
Ehlers-Danlos
liver diease
vascular disorder
vasculitis
thrombocytopenia causes
aplastic anemia
increase consumption of plt (disseminated intravascular coagulation)
immune thrombocytopenic purpura
thrombocytopenia plt amount
<150,000 plt/ul
von willebrand disease
type
type 1 - mild
severe - type 3
aspirin and NSAIDS effect
inhibits cyclooxygenase
plt function disorder (normal amount of plt)
e.g. bernard soulier disorder
problem in
gp IIb-IIIa
plt function disorder
e.g. bernard soulier disorder
problem in
GP - 1B
why uremia is added on prolonged bleeding?
kidney problems/toxins interferes with the bleeding time
problem in collagen production
scurvy disease - vitamin C deficiency
connective disease that targets vasuclar integrity - problem in collagen
Ehlers-Danlos
clinical aapplication of bleeding time
as diagnostic tool
assessment for bleeding
, monitoring drug effect\
indication of disease severity
not that significant and very rare
shortened bleeding time
shortened bleeding time
polycythemia vera
essential thrombocythemia (thrombosis and bleeding risk)
hypercoagulable disease
hypercoagulable disease causes
pregnancy
contraceptive use
thrombophilia
