•     Spontaneous, or excessive post-traumatic (immediate or delayed) bleeding may be an indication of a localized pathological process or a disorder of the haemostatic process.
  •     Accurate diagnosis and treatment –       pathophysiology of hemostasis.
  •     The process is divided into primary and secondary components.
  •           Primary hemostasis is formation of platelet plug at sites of injury and occurs within seconds of injury.
  •          Secondary hemostasis describes the coagulation system, which result in fibrin formation. It requires several minutes to complete.


  •       A family history for bleeding disorders may     be helpful for the assessment of pathologic   bleeding.
  •            The clinical setting of the bleeding patient:
    •             Acute massive mucocutaneous              bleeding without symptoms- immune            thrombocytopenic purpura (ITP).
    •             Massive bruising and oozing from               multiple sites in asymptomatic                 individuals-
    •                       accidental warfarin ingestion, or                   acquired factor VIII inhibitors           (particularly in older individuals).
    •             Postoperative bleeding at a surgical site         is usually related to a local surgical             problem.

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