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CION Cancer Clinics
Severe bleeding with a bleeding disorder: what to do now | CION Cancer Clinics
Call 108 or go to the nearest emergency department now. If someone with haemophilia, von Willebrand disease or a very low platelet count is bleeding heavily, or has bled into the head, throat, belly or a joint, it cannot wait. Say the diagnosis at the door and show their emergency card. This page explains which bleeds count as emergencies, what should happen at hospital and what to keep ready. At CION Cancer Clinics, our haematology team supports patients and families through treatment, cost questions and life at home.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Someone with a bleeding disorder is bleeding badly. What do you do now?
- Which bleeds count as an emergency?
- What should happen once you reach hospital?
- What do families often get wrong about bleeding emergencies?
- What should you keep ready before a bleed happens?
- What can this page not tell you?
- Common questions about severe bleeding with a bleeding disorder
Do this first
Someone with a bleeding disorder is bleeding badly. What do you do now?
Call 108 or go straight to the nearest emergency department. Do not wait to see whether the bleeding settles on its own. In a person with haemophilia, von Willebrand disease or a very low platelet count, a bleed that looks small from the outside can keep going on the inside.
While you wait or travel
Press firmly on any bleeding you can see, with a clean cloth, and keep pressing. Keep the person still and lying down if they feel faint. If the bleed is in a joint or a muscle, rest that limb and do not let them walk on it. Pick up their emergency card, the name of their bleeding disorder, the treatment they normally receive and the phone number of their haematology team.
If treatment is kept at home
Some families keep clotting factor at home and have been trained to give it. If your haematology team has given you a written bleeding plan, follow that plan. Giving home treatment does not replace going to hospital for a serious bleed. Take the used vial or its label with you, so the emergency team knows exactly what was given and when.
At the door, say the diagnosis before anything else. "He has severe haemophilia A" gets faster help than "he fell".Know the signs
Which bleeds count as an emergency?
These are the bleeds that need hospital straight away, even if the person says they feel fine.
Head, neck or throat
Any knock to the head, however minor. Swelling in the neck or throat can press on the airway, so treat it as urgent even before breathing becomes difficult.
Watch for
- Headache, vomiting or drowsiness
- Noisy breathing or trouble swallowing
Belly, back or groin
Bleeding deep inside the belly or into the muscle at the front of the hip can hide a lot of blood. Pain in the groin or lower back, or a leg the person will not straighten, needs checking now.
Joints and large muscles
A knee, elbow, ankle, thigh or calf that turns warm, tight, swollen or painful. Early treatment protects the joint from long-term damage.
Bleeding that will not stop
A cut, a tooth socket or a nosebleed that keeps going despite firm pressure. Also blood in vomit, black or bloody stools, or blood in the urine.
Heavy periods that soak through protection quickly belong here too.Not sure whether this applies to you?
Ask an oncologist
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What not to do first
Do not give any painkiller before asking the treating team, because some common ones make bleeding worse. Do not rub or massage a swollen joint. Do not wait for the morning clinic, and do not travel a long way to a particular hospital if a nearer emergency department can start treatment sooner. Call 108 if the person is drowsy, confused, struggling to breathe or losing a lot of blood.
At the emergency department
What should happen once you reach hospital?
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Triage, with the diagnosis said out loud
Show the emergency card and name the disorder. A person with a known bleeding disorder and a serious bleed should be seen quickly, not left in the queue.
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Treatment to help the blood clot
For haemophilia this is usually the missing clotting factor. For a very low platelet count it may be a platelet transfusion or another medicine. In a serious bleed, doctors often give this before scans, not after.
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Blood tests and scans
A blood count, clotting tests and a check for inhibitors, which are antibodies that can block factor treatment. A scan looks for hidden bleeding when the head, belly or hip is involved.
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Contact with the haematology team
The emergency doctors should speak to a haematologist about the right treatment and how often to repeat it. Give them your team's number.
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Watching and going home
Some bleeds need admission and repeated treatment. Before you leave, ask what signs mean you must come back.
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Commonly believed
What do families often get wrong about bleeding emergencies?
"The bleeding has slowed, so we can stay home."
Bleeding you can see may slow while bleeding inside carries on. In a joint, the belly or the head, the danger is often not visible at all. If the bleed was serious enough to worry you, it needs to be checked.
"We gave factor at home, so hospital is not needed."
Home treatment is a strong first step, not the whole answer. A head, throat or belly bleed still needs hospital, a scan and often more treatment. Your haematology team's written plan tells you which bleeds are safe to manage at home.
"The hospital will already know what to do."
Bleeding disorders are uncommon, and a busy emergency doctor may not know the patient's type, severity or usual treatment. The card and your clear words fill that gap in minutes.
"Girls and women do not get serious bleeding disorders."
Women can have von Willebrand disease, low platelets or carry haemophilia with low factor levels. Heavy periods, bleeding after childbirth and bleeding after a tooth is pulled deserve the same urgent attention.
Be ready
What should you keep ready before a bleed happens?
Keep this ready
Why it helps
An emergency card in the wallet or school bag
It names the disorder, its severity and the usual treatment
The haematology team's phone number saved on two phones
Emergency doctors can ask for advice straight away
Recent blood reports and any inhibitor result
Shows what treatment has worked before
The nearest emergency department you would use
Saves time deciding where to go at night
A written bleeding plan from the treating team
Tells the family which bleeds need hospital
Being straight with you
What can this page not tell you?
This page cannot tell you whether a particular bleed is safe to manage at home. Only the person's own haematology team can set that line, because it depends on the type of disorder, how severe it is and what treatment they already take. When you are unsure, treat the bleed as serious.
It is not a treatment plan
We do not give doses here, and nobody should start, stop or change a clotting treatment, blood thinner or transfusion on their own. The treating team decides that, often after blood tests. A low platelet count (thrombocytopenia, meaning too few of the cells that help blood clot) has several causes, and each one is treated differently.
Where CION fits
CION is not an emergency department. In a bleeding emergency, the nearest hospital that can start treatment comes first. After the emergency, CION's haematology team, led by Dr. Basudev Pokhrel, can review what happened, look at why the bleeding occurred and help plan care with qualified centres. Ask your team whether an inhibitor test, a written bleeding plan or a review of home treatment would help.
Reference ranges differ between laboratories. A single blood result is always read alongside symptoms and repeat tests.Questions we are asked
Common questions about severe bleeding with a bleeding disorder
Should I call 108 or drive to hospital myself?
Call 108 if the person is drowsy, confused, struggling to breathe, bleeding heavily or has hurt their head, neck or belly. If they are alert and the bleed is in a limb, going by car to the nearest emergency department is reasonable, as long as someone else drives. Do not delay to reach a far hospital.
What is haemophilia, in simple words?
Haemophilia is a condition where the blood is missing or low in a protein called a clotting factor. Without enough of it, a clot forms slowly and bleeding lasts longer. Haemophilia A is low factor VIII. Haemophilia B is low factor IX. It is usually inherited and mostly affects boys and men.
My child bumped a knee and it is swelling. Is that an emergency?
For a child with haemophilia, a swollen, warm or painful joint is a bleed until proven otherwise. Follow the written bleeding plan if you have one, and contact the haematology team or go to hospital the same day. Early treatment protects the joint. Do not wait for it to get worse.
Can a person with low platelets have the same emergencies?
Yes. A very low platelet count can cause bleeding from the gums or nose, blood in the urine or stool, and rarely bleeding inside the head. Treatment is different from haemophilia and depends on the cause. The same rule applies: a serious or unusual bleed needs the emergency department now.
What is an inhibitor, and why do doctors ask about it?
An inhibitor is an antibody the body makes against the clotting factor used for treatment. It stops the usual treatment from working well, so the doctors need a different approach. If your child has ever been told they have an inhibitor, say so at once and show the report.
Which painkiller is safe to give during a bleed?
Ask the treating team or the emergency doctor before giving any painkiller. Some common painkillers make bleeding worse, and what is safe depends on the person's disorder and other medicines. Write down any medicine already given at home, with the time, and hand the list to the doctor.
Is treatment for a bleeding emergency covered by a scheme?
Often some or all of it is. Aarogyasri, PM-JAY, CGHS, ECHS, EHS and many cashless insurance policies cover emergency admission, and some states supply clotting factor through government programmes. Rules change, so check the current terms. Never delay emergency care to sort out paperwork first.
What should we do after the emergency is over?
Book a review with the haematology team soon after discharge. Take the discharge summary, scan reports and the list of treatment given. Ask what caused the bleed, whether the home plan should change and whether more tests are needed. A calm review now helps you act faster next time.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. A haematology consultation can be booked at any of these centres through one helpline, and your team will tell you where each test or treatment takes place.
Warangal
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Sources
- NHS — Haemophilia
- National Heart, Lung, and Blood Institute — Hemophilia
- National Heart, Lung, and Blood Institute — Von Willebrand Disease
- American Society of Hematology — Bleeding Disorders
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Head Injury With Low Platelets or HaemophiliaWhy any knock to the head needs hospital the same hourBleeding on AnticoagulantsWhen the bleeding comes from a blood thinner insteadEmergency Card for Blood Disorder PatientsThe card to carry so hospital staff act fasterBenign Haematology EmergenciesEvery blood disorder emergency in one place
Talk to us
Had a bleeding emergency and need a haematology review?
In an emergency, go to the nearest hospital or call 108 first. Afterwards, tell us what happened and we will help you reach CION's haematology team.