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Bleeding Time Information

Bleeding time is a medical test done on someone to assess their platelet function.

The term "template bleeding time" is used when the test is performed to standardized parameters.[1] This makes it easier to compare data collected at different facilities.

Contents

Process

It involves cutting the underside of the subject's forearm, in an area where there is no hair or visible veins. The cut is of a standardised width and depth, and is done quickly by an automatic device.

A blood pressure cuff is used above the wound, to maintain venous pressure at a special value. The time it takes for bleeding to stop (as thus the time it takes for a platelet plug to form) is measured. Cessation of bleeding can be determined by blotting away the blood every several seconds until the site looks 'glassy'.

Ivy method

The Ivy method is the traditional format for this test. In the Ivy method, a blood pressure cuff is placed on the upper arm and inflated to 40 mmHg. A lancet or scalpel blade is used to make a stab wound on the underside of the forearm.

A standard-sized cut is made around 10 mm long and 1 mm deep. The time from when the stab wound is made until all bleeding has stopped is measured and is called the bleeding time. Every 30 seconds, filter paper or a paper towel is used to draw off the blood.

The test is finished when bleeding has stopped completely.

A normal value is less than 9 and a half minutes.[2]

A prolonged bleeding time may be a result from decreased number of thrombocytes or impaired blood vessels. However, it should also be noted that the depth of the puncture or incision may be the source of error.

Normal values fall between 2 - 9 minutes depending on the method used.

Duke Method

With the Duke method, the patient is pricked with a special needle or lancet, preferably on the earlobe[3] or fingertip, after having been swabbed with alcohol. The prick is about 3-4 mm deep. The patient then wipes the blood every 30 seconds with a filter paper. The test ceases when bleeding ceases. The usual time is about 1-3 minutes.

Interpretation

Bleeding time is affected by platelet function, certain vascular disorders and von Willebrand Disease--not by other coagulation factors such as haemophilia. Diseases that cause prolonged bleeding time include thrombocytopenia, disseminated intravascular coagulation (DIC), Bernard-Soulier disease, and Glanzmann's thrombasthenia.

Aspirin and other cyclooxygenase inhibitors can prolong bleeding time significantly. While warfarin and heparin have their major effects on coagulation factors, an increased bleeding time is sometimes seen with use of these medications as well.

People with von Willebrand disease usually experience increased bleeding time, as von Willebrand factor is a platelet agglutination protein, but this is not considered an effective diagnostic test for this condition.

It is also prolonged in hypofibrinogenemia.[4]

Condition Prothrombin time Partial thromboplastin time Bleeding time
Vitamin K deficiency prolonged prolonged unaffected
Disseminated intravascular coagulation prolonged prolonged prolonged
Haemophilia unaffected prolonged unaffected

References

  1. ^ "CLIA Corner". http://www.uhl.uiowa.edu/publications/archive/hotline/1998/1998_07/clia.xml. Retrieved on 2009-05-18.
  2. ^ "Blood Chemistries". http://www.obgyn.ufl.edu/obgyn101/Lab/Blood%20Chemistries.htm. Retrieved on 2009-01-02.
  3. ^ Schafer, Andrew I.; Loscalzo, Joseph (2003). Thrombosis and hemorrhage. Hagerstwon, MD: Lippincott Williams & Wilkins. pp. 397. ISBN 0-7817-3066-X.
  4. ^ "Bleeding Time". http://www.obgyn.ufl.edu/obgyn101/Lab/Bleeding%20Time.htm. Retrieved on 2009-01-02.

External links

MedlinePlus Medical Encyclopedia

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Serology, reference range: blood tests
Clinical biochemistry
Metabolic panel BMP: electrolytes (Na+/K+, Cl-/HCO3-) · renal function, BUN-to-creatinine ratio (BUN/Creatinine) · Glucose · Ca

CMP: BMP + protein tests (Human serum albumin, Serum total protein) · liver function tests (ALP, ALT, AST, Bilirubin)

derived values: Plasma osmolality · Serum osmolal gap
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Other Beutler test · MELISA · RAST test · Blood lipids · Tumor marker
Hematology
Clotting vWF: Ristocetin induced platelet agglutination

clotting factors: Prothrombin time · Partial thromboplastin time · Thrombin time other/general coagulation: Bleeding time · animal enzyme (Reptilase time, Ecarin clotting time, Dilute Russell's viper venom time) · Thromboelastography

fibrinolysis: Euglobulin lysis time · D-dimer
CBC/Red blood cell indices Hematocrit · Hemoglobin · RBC count

ratios: Mean corpuscular hemoglobin · Mean corpuscular hemoglobin concentration · Mean corpuscular volume

Fetal hemoglobin: Apt-Downey test · Kleihauer-Betke test · Red blood cell distribution width
Other Blood film · Reticulocyte index · Blood viscosity · Absolute neutrophil count · Haptoglobin
Immunology
Infections viral infection: HIV (HIV test, BDNA test) · Epstein-Barr virus (Monospot test)

bacterial infection: syphilis (VDRL, Rapid plasma reagin, Wassermann test, FTA-ABS) · rickettsia (Weil-Felix test) · helicobacter (HelicoCARE direct) · streptococcus (Antistreptolysin O titre)

protozoan infection: toxoplasmosis (Sabin-Feldman dye test)
Inflammation C-reactive protein · Erythrocyte sedimentation rate
see also reference ranges for blood tests

Categories: Blood tests

 

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