Canterbury DHB

Context

Management

Note: These recommendations are based on the New Zealand National Guidelines for the Management of Haemophilia. There are some differences and where these exist the local practice outlined here should be followed.

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:

Mark Smith (see Who's Who)

Issue Date:

August 2016

Next Review:

August 2019

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5233