The EM Educator Series: Bleeding until proven otherwise…

Author: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome to this week’s EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. We are working on retroactively doing this for the past posts as well. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Mini Case: Bleeding until proven otherwise…

A 12-year-old male is brought in by EMS after a fall from the monkey bars at school. He hit his head, and upon presentation, appears altered. He has a significant hematoma. His mother rushes into the room and tells you he has a history of hemophilia A. Your heart skips a beat with this new information.



  1. What are the different types of hemophilia?
  2. How do these patients present, and what do you need to consider in evaluating/managing these patients?
  3. ED work-up; don’t wait to return!!
  4. How do you provide factor replacement (bleeding site dependent)?
  5. How can you use your cognitive approach to high-risk, low prevalence diseases (such as hemophilia) and apply these concepts and lessons learned elsewhere?


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