hemophilia and injections

[AndyDufrane]

so I got asked today if its ok for a patient who had hemophilia down in PMH to proceed w/ an fluoro guided hip intraarticular injection, the patient had already had lumbar RFA in the past, this seemed like an obvious contraindication, and if not, I was not sure what one must do to do an injection safely in hemophilia patient, are there certain medications the patient should be given, Vitamin K, or frozen plasma, I know this seems like a dumb silly question

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[SSdoc33]

so I got asked today if its ok for a patient who had hemophilia down in PMH to proceed w/ an fluoro guided hip intraarticular injection, the patient had already had lumbar RFA in the past, this seemed like an obvious contraindication, and if not, I was not sure what one must do to do an injection safely in hemophilia patient, are there certain medications the patient should be given, Vitamin K, or frozen plasma, I know this seems like a dumb silly question

There are different types and different severities. A joint injection is probably ok, but you should check the their hematologist

 

[SSdoc33]

so I got asked today if its ok for a patient who had hemophilia down in PMH to proceed w/ an fluoro guided hip intraarticular injection, the patient had already had lumbar RFA in the past, this seemed like an obvious contraindication, and if not, I was not sure what one must do to do an injection safely in hemophilia patient, are there certain medications the patient should be given, Vitamin K, or frozen plasma, I know this seems like a dumb silly question

There are different types and different severities. A joint injection is probably ok, but you should check with their hematologist

 

[Gauss]

if you get a hemarthrosis in a hemophiliac what will stop the bleeding? Are they taking any clotting factors? Blood injections into joints is the next rage but someone with uncontrollable bleeding is another issue entirely

 

[RUOkie]

so I got asked today if its ok for a patient who had hemophilia down in PMH to proceed w/ an fluoro guided hip intraarticular injection, the patient had already had lumbar RFA in the past, this seemed like an obvious contraindication, and if not, I was not sure what one must do to do an injection safely in hemophilia patient, are there certain medications the patient should be given, Vitamin K, or frozen plasma, I know this seems like a dumb silly question

If they are Factor VIII deficient, I would give them factor before the injection much like before any surgery. IF you give them a hip hemarthrosis, you just bought them a THA, and that will have a high degree of morbidity (and mortality). Think about how much blood people lose who are NOT hemophiliacs.

If this is a lesser factor deficit, then it is less of a big deal

Get the recs from the hematologist IN WRITING before the procedure.

 

[Jitter Bug]

Never let the bravura of the last proceduralist give you a false sense of security.

Agree with above: hemophilia has enough variability and rarity that I would want to speak with hematology. And have a plan in place for stopping the bleeding if things go south

not "Page hematology STAT! "

 

[HemOncGuy]

I know this is an old thread, I myself am a severe Hemophiliac, type A Factor VIII deficient. If I were the patient, as stated above, I would simply need to prophylactically administer my Recombinant Anti-Hemophilic Factor intravenously (This is not human product, rather produced in a lab). If, however the patient had no access to Anti-Hemophilic Factor, I would consider blood transfusion. All in all, I think it would be best to consult with Hematology, as any procedure can pose exponential risks for Hemophiliac patients.