HealthInfo Canterbury
Treating haemophilia
If you have haemophilia, the aim of treatment is to reduce the risk of you getting bleeding that doesn't stop (prolonged bleeding) and bleeding too much. Bleeding can be controlled by injections of a clotting factor medicine.
Clotting factor medicines are very concentrated. A small amount can control major bleeds, even in surgery. Treatment needs to be given as quickly as possible to prevent long-term damage. The medicine can be effective for up to three days.
Most clotting factor medicines are made using genetic engineering to create artificial products that contain no human blood parts. Those that are made from donated human blood are strictly tested and made as safe as possible using steps to stop any viruses growing.
There are two main approaches to treatment, depending on the severity of your condition.
Preventative therapy
Most people with haemophilia need preventative treatment (prophylaxis). You get regular injections of clotting factor medicine to help prevent episodes of bleeding and prevent joint and muscle damage. Preventative therapy aims to keep the levels of clotting factor in the blood high enough that clots can form easily if a bleed occurs. Preventative therapy gives children the best chance to grow up without damage to their joints.
On-demand therapy
In mild or moderate cases, treatment for haemophilia may only be necessary if you are bleeding. It's essential to get treatment early so there's less chance of long-term damage and disruption to daily life. If you are treating a bleed at home or outside of the hospital you should:
- inject the clotting factor medicine as soon as possible
- contact your haemophilia centre to arrange for an appointment to see your nurse or physiotherapist
- start to follow the P.R.I.C.E regimen (Protection, Rest, Ice, Compression, Elevation).
- Protection: protect your joint by not putting weight on it, at least for the first 48 hours, and possibly longer if it's a heavy bleed. Use crutches or other supports.
- Rest: completely rest the affected area, to let the swelling ease and prevent further bleeding, but remember, too much rest can also be damaging, so start to move the joint gently within one to two days of treatment.
- Ice: applying ice helps to reduce swelling, prevent further bleeding and eases pain. Don't put ice directly on the skin as it can burn. Instead use a gel cold pack or make a cold pack from a bag of frozen peas or crushed ice wrapped in a cloth. Apply to the affected area for around 10 to 15 minutes every two hours. Don't leave it on for more than 20 minutes at a time.
- Compression: apply pressure and a bandage to the affected area, to reduce swelling and pain. Your physiotherapist can provide you with an elasticated bandage and will make sure it fits properly. A bandage that fits too tightly can cause more damage. Try not to let the bandage get wrinkled and take it off at night.
- Elevation: raise the injured area above the level of your heart. This increases blood flow away from the injured area and reduces swelling and pain. When you elevate your leg, take off the bandage to allow for normal circulation. Elevate for about 20 minutes at a time.
Managing pain
You will need treatment to manage pain, as swelling caused by bleeds, especially in the joints, can be extremely painful. You need to avoid aspirin and most non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen as they suppress platelet function and reduce blood clotting. Talk to your doctor or pharmacist before trying any pain medication to discuss possible side effects.
Physiotherapy
Physiotherapy after a bleed helps with recovery from internal bleeding that may have damaged your joints. Your physiotherapist will give you good exercises to get your muscles and joints working again.
Content shared between HealthInfo Canterbury, KidsHealth and Health Navigator NZ as part of a National Health Content Hub collaborative. Endorsed by clinical director, Haematology Department, Canterbury DHB. Page created May 2020.
Review key: HIBLD-52881
