Protocols - Hemorio

Tranexamic acid
- 15-25mg/kg PO 8/8 h
- 500-1000 mg IV 8/8 h.
- Solution at 5% to rinse in the mouth: 10ml (6 times a day).
Desmopressin or DDAVP: analog synthetic of vasopressin (antidiuretic hormone). This is indicated for
patients with mild hemophilia, von Willebrand disease, purpuras with alteration of platelets pool and
Bernard Soulier syndrome, after therapeutic test. See using, administration and DDAVP doses , at von
Willebrand disease treatment.
DRUGS THAT MIGHT BE AVOIDED IN PATIENT WITH HEMORRHAGIC SYNDROME
- acetylsalicylic acid
- Fenilbutazone, indometacine and other anti-inflammatory
- Antihistaminic
- Penicillin and derivates
- Expectorant (most of has derivates of guaiacol that alters platelets function)
HOSPITALIZATION INDICATIONS
- Volume hemarthrosis, relapses
- Volume Hematomas at risk site (ileopsoas, calves, forearm, tongue and neck)
- Neurologic signals and symptoms
- Surgeries: pre and post surgery
- Acute abdomen suspicion
- Major hemorrhages
1- HEMOPHILIA
CLINICAL FOLLOW-UP OF HEMOPHILIC PATIENT
In hemophilic patients, all exams must be asked, every 6 months, except hemostasia study that will be
replaced by research of periodic inhibitor. Patient who experiences positive inhibitor ins some phase of
their evolution, must write down this fact in the medical chart so that any physician that, in the future, see
him/her may know about it. As of this date, the control will be every three months with research and
dosage of the inhibitor
PATIENTS WHO GO TO EMERGENCY ROOM AND DO NOT HAVE INHIBITOR RESEARCH, AT THE
EXPECTED TERM, THIS MUST BE REQUIRED, IN THE EMERGENCY, BEFORE THE BEGINNING OF
REPOSITION TREATMENT .
Radiologic exam of joints has to be performed in patients who had submitted to hemarthrosis at periodical
consultations intervals (at medical discretion).
57