Nursing Management of Haemophilia and von Willebrand Disorder
Version No. 2
Effective Date: 01/07/2013
Review Date: 01/07/2015
• In the absence of a documented baseline factor level dosing is calculated as if
the factor level is 0%
• As baseline factor levels remain unchanged, factor levels do not need to be
checked before factor treatment is initiated
• R.IC.E. – Rest, Ice, Compression and Elevation are simple measures which can
be beneficial
• Avoid intramuscular (IM) injections and NSAID’s.
• Lumbar punctures and other such invasive needles should only be performed
after an appropriate dose of factor has been administered
• If significant trauma has occurred and the patient can demonstrate his
haemophilia diagnosis, do not wait for obvious signs of bleeding
• In most circumstances patients will require more than one dose to treat a bleed
• If in doubt, treat with appropriate factor immediately.
• In most cases, the haemophilia patient is well aware of the correct treatment
required for his disorder and his opinions and comments should be treated with
respect.
• Patients may be very protective of their veins and are often expert at the
placement of intravenous needles as they self access them during home therapy
use of factor VIII or factor IX.
• A haemophilia patient may become assertive if treatment is delayed. This is
because he has been educated by his haematologist to seek a factor VIII or IX
infusion as an urgent measure.