have a bleed in the iliopsoas muscle, they sometimes have symptoms similar to appendicitis. Involving the team from the hemophilia treatment center (HTC) is critical to ensure appropriate diagnosis and management to minimize delays in care. Bleeding into the long muscles of the forearm, hand, or calf can put pressure on nerves and muscles. The pressure may cause severe pain or numbness below the bleed. This is called compartment syndrome . A compartment bleed is a limb-threatening bleed. It is important to report bleeding in these muscles or any of these symptoms to your child’s physician and seek treatment immediately. Mouth Bleeding Children with hemophilia can have prolonged bleeding from the mouth when they injure their teeth, lips, or gums. Prolonged bleeding also can happen when a child gets new teeth or loses teeth. Mouth bleeding may happen after an injury or a dental procedure such as an extraction or root canal. Mouth bleeding may seem worse because the blood mixes with saliva, making it look as though your child is losing more blood than they are. Applying cold with an icy drink or Popsicle (avoid red-colored drinks/ Popsicles) can help stop the bleeding. Bleeding that continues for more than 30 minutes should be reported to the hematologist. Having hemophilia does not cause dental problems. Children with hemophilia should have regular dental cleanings so they can avoid dental issues that may require invasive procedures or cause bleeding. Nose Bleeding Hemophilia does not cause nose bleeds, but having hemophilia may make nose bleeds from other causes (e.g., allergies, injuries) last longer. Nose bleeds usually are not serious. Applying pressure to the nose for 10–15 minutes, while your child sits upright, usually helps stop the bleeding. Contact your physician if bleeding continues after 20 minutes despite pressure and other first aid measures. If your child has frequent nose bleeds, it may be helpful to find out if there is a reason. If you can identify the reason for the bleeds, you may be able to decrease the number of bleeds. Eye Bleeding You should have any injury to your child’s eye examined by their physician right away. Bleeding in the eye could result in blindness. Neck and Throat Bleeding An injury to the neck or throat could lead to bleeding that will affect your child’s ability to breathe and swallow. Seek immediate medical care if your child’s neck becomes swollen or if they have trouble breathing or swallowing. If your child is vomiting bright red blood or what looks like coffee grounds, you should call your child’s physician immediately. Abdominal Bleeding Abdominal bleeding can go on for a long time before there are symptoms. Any trauma to the abdomen should be discussed with your child’s physician. Symptoms of bleeding in the abdomen, stomach, or intestines include vomiting a bright red or “coffee ground” substance. You also may see black or tar-like stools. Because the bleeding can go on for a long time, your child may look pale and feel tired. Your
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