Management

Self-treatment is the aim for most severely affected haemophiliac patients. Early home treatment results in a rapid response and reduces costs compared with inpatient or outpatient care. In children, the aim is to prevent or delay the onset of haemophilic arthritis.

If patients are not suitable for a home therapy program, either because of age or infrequent bleeding, then they must attend the Hospital for treatment without delay. These patients should have easy access to the doctors and nurses who give them their treatment. When treatment is given, this should be appropriate and by a person with experience in the management of patients with bleeding disorders.

Our aim is to provide a comprehensive service for 24-hour treatment and advisory service for patients with bleeding disorders. During working hours, this is provided at the Haemostasis Service and Paediatric Outpatients. At night and on weekends, the haemophiliacs report directly to the Clinical Haematology Unit or the Paediatric Wards depending on their age.

Supervision of patients on home treatment programs involves regular checks on blood product usage, joint problems, and monitoring for possible complications.

A total care approach to the patient is necessary and this involves haematologists, paediatricians, nurses, physiotherapists, orthopaedic surgeons, dentists, social workers, and many more. This should be borne in mind by anyone who sees a patient with a bleeding disorder and he/she should remember to ask someone more senior if they are concerned about any aspect of an individual patient's care.

National Guidelines

We have adopted the National guidelines, with some modifications, and these form the basis of this section. This information is a treatment guideline only and is not intended as a substitute for consultation with a haematologist, or paediatrician experienced in the management of haemophilia and (usually) associated with a Regional Haemophilia Centre. All patients with haemophilia admitted to hospital must be discussed with the Regional Haematologist.


About this Canterbury DHB document (5233):
Document Owner:	Sean Macpherson (see Who's Who)
Last Reviewed:	November 2019
Next Review:	November 2022
Keywords:
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer The Haematology Department Protocols and Guidelines (the Red Book) are intended as a guide for registered health professionals to communicate guidelines and share best practices with supporting health professionals within New Zealand district health boards. They are not intended to be provided to or used as a reference for patients or non-registered health professionals. All health professionals must exercise their own clinical judgement and use pertinent clinical data when treating patients. The authors and editors of this publication have checked with sources believed to be reliable in their effort to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical science, neither the authors, editors, publisher, nor any other party who has been involved in preparing or publishing this work warrants that the information contained in it is accurate or complete in every respect. They therefore have no liability (whether in tort (including negligence) or otherwise) for any loss or damage arising out of any reliance on this information. This publication has been compiled by the staff and contractors of Canterbury District Health Board (CDHB) and as such CDHB has copyright for this book. Amendments must be authorised in accordance with the documented process. No release of part of, or all of, this publication to any other party or organisation is permissible without the prior approval of the designated document owner.
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