Management of acute hemorrhage in patients with hemophilia or von Willebrand disease in the emergency department

Patients with hemophilia or von Willebrand disease may present to the emergency department (ED) with life-threatening bleeding, as severe hemorrhage can lead to hemodynamic instability and bleeding in the central nervous system, throat, and neck. Thus, inappropriate, or delayed management could lead to serious treatment-related complications or even death, and therefore, emergency medical staffs should be well-equipped with the latest knowledge to properly and timely treat these patients. The goal of treatment in emergency settings is to achieve hemostasis by replacing clotting factor levels, prevent hemodynamic instability, and prompt initiation of further specialized treatments. In this study, we searched Medline, PubMed, Embase and Google Scholar for papers addressing hemophilia- and Von Willebrand disease (VWD)-related bleeding and factors in emergency settings to determine evidence-based approaches for managing severe hemorrhage in these patients in the ED.