Blood Clotting
The body’s first response to such injury is made by blood elements called platelets. These disk-like elements stick to the damaged area of the vessel wall and form a soft plug or patch. This plug is then reinforced by the clotting factors of the blood’s plasma. These factors and the platelets form a thick covering over the loose plug and prevent further bleeding.
If this thick covering is on the skin surface, it appears a scab. Eventually, the plug is dissolved as the injured tissue heals.
Bleeding from small blood vessels usually stops within 5 to 10 minutes. You can help clotting by applying cold compresses to the injured area. The cold shrinks the blood vessels that supply the injured area, reducing the flow of blood. The pressure of the compress helps the plug to form. But if you continually wash the damaged area, the platelets and clotting factors are bathed away and no clot can form.
If your child injures a large blood vessel, the blood clotting process cannot form a plug. Severe bleeding results. To stop the bleeding, apply direct pressure to the wound. Fold a towel or handkerchief into a pad, and hold it on the wound. If you cannot find a cloth quickly, apply pressure with your hand. If the bleeding persists, take the child immediately to the hospital. Sometimes blood clotting occurs in blood vessels that have not been injured physically. This clotting is called thrombosis. Thrombosis blocks blood vessels and reduces the flow of blood. The reduction of blood flow to a vital organ can result in permanent injury to the organ.
Unusual bleeding, for example, bleeding without injury, excessive bleeding from a slight injury, or bleeding that will not clot, occurs for a variety of reasons. A child may have excessively fragile or diseased blood vessels, not enough platelets or defective platelets, or plasma that may lack clotting factors. The lack of clotting factors is known as hemophilia.
HEMOPHILIA
Hemophilia is a hereditary disease in which the blood does not clot properly and bleeding is difficult to stop. Hemophilia occurs almost entirely in males. Women, rarely show signs of the disease, but they carry it and transmit it to their sons.
Hemophilia varies from severe forms in which bleeding occurs after almost any activity, to milder forms in which only major injuries or surgery produce excessive bleeding. The bleeding may occur internally as well as from a cut on the skin. Internal bleeding usually occurs in body tissues, in muscles or in joints such as those at the knee, ankle, elbow or hip.
No cure has been yet found for hemophilia, but bleeding can be controlled with normal blood plasma or with concentrates of clotting factors (medicines that help clot the blood). Prompt medical treatment can prevent large hemorrhages that might permanently damage joints, tissues or organs. Surgery and dental extractions can be performed without danger of hemorrhage if the child with hemophilia is first treated with plasma or the concentrates of the clotting factors. Hemophilia is sometimes apparent in new born infants.
They bleed excessively from the umbilical cord or following circumcision. More commonly, the disease becomes evident when the child begins to crawl or walk. Small bumps cause large bruises and swelling, which are signs of large areas of hemorrhage. If this happens, have the child examined immediately by your doctor. If you know there is a history of hemophilia in your family, report this to the doctor who will deliver the baby and to the baby’s pediatrician. The baby’s doctor will probably want to examine the child at about 3 months.
Once hemophilia is diagnosed, doctors usually recommend protecting the child from activities that might produce injury. For example: discouraging tree climbing or physical contact sports such as football.
