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Published on: November 3, 2023
Insights
Pediatricians face challenges distinguishing normal childhood bleeding from serious conditions. This review offers guidance on evaluating abnormal bleeding and hemostasis in children.
Area of Science:
- Pediatric Hematology
- Clinical Pediatrics
Background:
- Abnormal bleeding and bruising are common reasons for pediatric primary care visits.
- Distinguishing age-appropriate bleeding from pathological bleeding can be challenging for primary care providers.
Purpose of the Study:
- To review considerations for abnormal bleeding in pediatric patients.
- To outline an initial approach for evaluating hemostasis in children presenting with bleeding symptoms.
Main Methods:
- Literature review of pediatric bleeding disorders and hemostasis evaluation.
- Discussion of common bleeding scenarios in children.
Main Results:
- Provides criteria to help differentiate normal from abnormal bleeding in children.
- Suggests a systematic approach to the initial hemostasis evaluation.
Conclusions:
- Effective evaluation of pediatric bleeding requires careful assessment of symptoms.
- A structured approach aids primary care providers in managing children with bleeding concerns.
Abstract:
Abnormal bleeding or bruising is a relatively common clinical concern, frequently causing parents to seek care from their children's primary care provider. Although ecchymosis from playful trauma, occasional epistaxis, and heavy menstrual bleeding around the time of menarche and beyond are common occurrences, it can be difficult for pediatricians and other primary care providers to determine if their patient has age-appropriate symptoms versus abnormal or excessive bleeding. This review discusses considerations for abnormal bleeding in pediatrics and discusses an initial approach for evaluation of hemostasis in a child with bleeding symptoms. [Pediatr Ann. 2020;49(1):e36-e42.].
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