HEMOPHILIA: WHAT SCHOOL PERSONNEL SHOULD KNOW

HEMOPHILIA
WHAT SCHOOL PERSONNEL SHOULD KNOW

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TABLE OF CONTENTS
Introduction
p. 3
What Is Hemophilia
p. 4
Common Bleeds
p. 5
Superficial Bruising
p. 8
Lacerations
p. 8
Life-Threatening Bleeds
p. 9
Sports and Activities
p. 12
Absenteeism
p. 13
Summary
p. 14
Acknowledgements
p. 15

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INTRODUCTION
Teachers and other school personnel may feel anxious about having
a student with hemophilia in their school. This booklet is designed to
alleviate those fears by presenting facts about hemophilia and
provides a quick reference guide on what to do in different situations
of bleeding. Educators need to be aware that students with hemophilia
do not bleed any faster than other students; however, they may have
prolonged or delayed bleeding.
This booklet uses the terms “he,” “him” and “his” throughout the text
as most people with hemophilia are males. This does not deny that
many girls may have bleeding disorders.
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WHAT IS HEMOPHILIA?
Hemophilia is a hereditary bleeding disorder, usually affecting males.
This results in prolonged bleeding, primarily into muscles and/or
joints. People with hemophilia have difficulty with their blood clotting
and may bleed longer than normal. This can be prevented if they
receive appropriate treatment.
Hemophilia can affect any race, nationality or social class. It occurs in
approximately 1:10,000 male births. Occasionally, female carriers of
hemophilia will have bleeding symptoms.
Hemophilia has three levels of severity: mild, moderate and severe.
Severity of bleeding may differ from individual to individual but they
all have the potential to bleed with injury. At present there is no cure
for hemophilia; however, individuals with hemophilia can lead a
relatively normal life while taking preventative measures to avoid
bleeding episodes. There are treatment options available and
necessary for many students with hemophilia. It is important for
school personnel to acknowledge the student’s concern of a
bleeding episode, and to recognize signs of bleeding and take
appropriate action.
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COMMON BLEEDS
MOUTH BLEEDS Bleeding in the mouth may be troublesome as it is
messy, but it is usually minor. Blood mixed with saliva sometimes
makes the bleeding look worse than it is. Encourage the student to
spit out rather than swallowing blood to avoid an upset stomach.
IF A STUDENT HAS OOZING FROM A CUT IN THE MOUTH,
WE RECOMMEND YOU:
• Put on protective gloves.
• Apply firm continuous pressure to the site of bleeding,
if possible with a cold cloth for 20 minutes.
• Encourage popsicles or ice.
• Call the parents/guardian for instructions if bleeding has
not stopped after 20 minutes.
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NOSE BLEEDS Nose bleeds may vary in students and are usually not
serious. A nose bleed is treated the same as for any other student.
IF A STUDENT HAS A NOSE BLEED, WE RECOMMEND YOU:
• Put on protective gloves.
• Position the student sitting with head slightly forward.
• Apply firm continuous pressure under the bridge (bone) of
the nose with a cold cloth for 20 minutes.
• Encourage popsicles or ice.
• Call the parents/guardian for instructions if bleeding has
not stopped after 20–30 minutes.
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JOINT AND MUSCLE BLEEDS The beginning of a bleeding episode
in a joint and/or muscle may not be readily apparent. The student may
be reluctant to use a limb or he may tell you it feels funny or that he
thinks that he is having a bleed. If there is bleeding in a joint or
muscle, it will gradually swell, feel hot to touch and become painful.
The joints that most commonly bleed are ankles, knees and elbows.
Muscle bleeds can occur anywhere in the body.
IF A STUDENT HAS A JOINT OR MUSCLE BLEED,
WE RECOMMEND:
R.I.C.E.
R - REST; Keep the student still to avoid further injury while
waiting for the parents/guardian.
I - Apply ICE; do not leave longer than 20 minutes and make
sure there is a cloth layer between ice and bare skin.
C - COMPRESSION; wrap limb with elastic bandage.
E - ELEVATE the body part.
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SUPERFICIAL BRUISING Students with hemophilia often have bruises
on their extremities. These usually are superficial and generally are no
cause for alarm. Notice must be paid to the student who expresses
ongoing pain at the bruised site.
LACERATIONS If bleeding occurs from a cut, scrape or laceration, the
first aid treatment is the same as with any other student.
IF A STUDENT WITH HEMOPHILIA SUSTAINS A CUT OR
LACERATION, WE RECOMMEND YOU:
• Put on protective gloves.
• Clean cut with a skin antiseptic.
• Apply firm continuous pressure until bleeding stops.
• Apply a band-aid or dressing.
• Contact the student’s parents/guardian for instructions or
seek medical help if bleeding continues for more than
20 – 30 minutes.
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LIFE-THREATENING BLEEDS
BLEEDING INTO THE HEAD, NECK, CHEST OR ABDOMEN MAY BE
LIFE-THREATENING AND REQUIRES IMMEDIATE MEDICAL ATTENTION.
In the absence of symptoms, notify the student’s parents/
guardian as symptoms may appear later.
HEAD INJURY All head injuries are to be considered serious
because of the risk of a brain hemorrhage.
Symptoms of a brain hemorrhage are:
• Loss of consciousness
• Nausea and/or vomiting
• Drowsiness
• Dilated or unequal pupils
• Dizziness
• Headache
• Irritability
• Confusion
• Lethargy
• Unsteady gait
IF THE STUDENT SUFFERS A HEAD INJURY,
WE RECOMMEND YOU:
• SEEK IMMEDIATE MEDICAL ATTENTION.
• Notify the student’s parents/guardian immediately.
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NECK INJURY OR BLEEDS Neck bleeding is a serious bleed because
of the potential of blocking the airway. Any injury to the area as well
as the student’s expression of pain and tenderness should be attended
to promptly. Failure to do so could result in the student having
difficulty in swallowing or breathing.
IF A STUDENT IS SUSPECTED OF HAVING A NECK BLEED,
WE RECOMMEND YOU:
• SEEK IMMEDIATE MEDICAL ATTENTION.
• Notify the student’s parents/guardian immediately.
CHEST INJURY OR BLEED Injuries to the chest wall may be very
painful if there is bleeding into the muscles between the ribs.
Bleeding in this area needs prompt medical attention.
IF A STUDENT SUFFERS A BLOW TO THE CHEST AREA,
WHETHER THERE ARE ANY SIGNS OF BLEEDING OR NOT,
WE RECOMMEND YOU:
• SEEK IMMEDIATE MEDICAL ATTENTION.
• Notify the student’s parents/guardian immediately.
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