The National Hemophilia Foundation’s (NHF) Nursing Working Group has been revising and expanding the Nurses’ Guide to Bleeding Disorders (NGBD). First published in 1995, the guide provides comprehensive information and practical ideas to assist nurses at all levels in caring for patients with bleeding disorders.
Over the last several years, the NGBD has further evolved into a readily accessible online resource, serving as an introduction to nurses new to coagulation and as an information source for more experienced nurses. New chapters, which continue to be added in downloadable PDF format, cover a wide range of topics such as hepatitis, orthopedics, pain, rare bleeding disorders and women with bleeding disorders.
In “Common Bleeding Episodes,” authors Ellen White, RN, MSN, and Beverly Christie, RN, ACRN (originally authored by Carol Orto, RN, BSN, MPA), explain how and why certain persistent-type bleeds occur in individuals with hemophilia and similar disorders. The incidence, assessment and clinical management of joint bleeding (hemarthrosis), an often pervasive bleed in moderate and severe patients, occupies a significant portion of the chapter. The authors describe established approaches to proactive modes of joint bleed prevention, including exercise and prophylactic factor treatment regimens. The chapter also covers other common symptoms such as menorrhagia (heavy menstrual bleeding), soft tissue bleeding, nosebleeds (epistaxis) and oral bleeding.
