Protocols - Hemorio

HEMATURIA:
- DO NOT start replacement therapy, at first.
- General care: bed rest, vigorous hydration (oral). Avoid urinary infection
- If in 72 hours macroscopic hematuria does not give in, increase FVIII or FIX according to Table 3, until
macroscopic hematuria disappears.
- After hematuria is resolved, investigate etiology (ultrasound of urinary ways, EAS, excretion urography).
- In refractory cases - Prednisone 1 to 2mg/kg weigh / day for 2 days.
- NEVER administer Antifibrinolytics.
GI HEMORRHAGE:
- Replacement of deficient factor (Table 3)
- Antifibrinolytics
- General clinical care: diet, antacid, ranitidine or omeprazol.
- Hemostatic packed may be considered as a therapeutic option.
Note: Use in HDA cases, before and after cauterization: hemostatic packed: gelfoan 10 cm + adrenaline 1
ampoule + EACA 1-4g + SF0, 9%%, 250ml water or cold milk. Mix and drink 100ml 1/1h PO.
CRANIAL TRAUMA:
- MINOR TRAUMA: increase FVIII or FIX to 50%, every 24 hours, during 3 days;
- MAJOR TRAUMA: increase F VIII or IX according to table 3.
It is necessary to confirm the diagnosis of intracranial hemorrhage with:
1- Neurological evaluation
2- Fundus of eye evaluation
3- Cranial x-ray – fracture evaluation
4- Cranial CT always; in case there is no bleeding image, repeat it in 15 days for control.
- LIQUOR PUNCTURE REQUIRED: perform replacement of FVIII or IX according to Table 2.
63