{"id":176,"date":"2014-03-17T02:50:44","date_gmt":"2014-03-17T02:50:44","guid":{"rendered":"https:\/\/www.pupdoc.ca\/?page_id=176"},"modified":"2025-10-08T14:50:40","modified_gmt":"2025-10-08T14:50:40","slug":"bruising-bleeding","status":"publish","type":"page","link":"https:\/\/www.pupdoc.ca\/en\/bruising-bleeding\/","title":{"rendered":"Bruising \/ Bleeding"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; inner_shadow=&#8221;on&#8221; fullwidth=&#8221;on&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#961622&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header title=&#8221;Bruising \/ Bleeding&#8221; text_orientation=&#8221;center&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;rgba(255, 255, 255, 0)&#8221; global_colors_info=&#8221;{}&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_one_text_size__hover=&#8221;null&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover=&#8221;null&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_one_text_color__hover=&#8221;null&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover=&#8221;null&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_one_border_width__hover=&#8221;null&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover=&#8221;null&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_one_border_color__hover=&#8221;null&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover=&#8221;null&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover=&#8221;null&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover=&#8221;null&#8221; button_one_letter_spacing__hover_enabled=&#8221;off&#8221; button_one_letter_spacing__hover=&#8221;null&#8221; button_two_letter_spacing__hover_enabled=&#8221;off&#8221; button_two_letter_spacing__hover=&#8221;null&#8221; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover=&#8221;null&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover=&#8221;null&#8221;][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; inner_shadow=&#8221;on&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#ffffff&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_tabs module_class=&#8221;key-conditions&#8221; _builder_version=&#8221;4.27.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; hover_enabled=&#8221;0&#8243; z_index_tablet=&#8221;500&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_tab title=&#8221;Key Conditions&#8221; _builder_version=&#8221;4.16&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; global_colors_info=&#8221;{}&#8221;]Hemophilia<br \/>\nIdiopathic thrombocytopenic purpura<br \/>\nLeukemia<br \/>\n[\/et_pb_tab][et_pb_tab title=&#8221;Foundational Knowledge&#8221; _builder_version=&#8221;4.27.4&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<ul>\n<li>Describe the mechanism of hemostasis: platelet plug formation, coagulation cascade and clot stabilization<\/li>\n<li>Demonstrate an approach to the interpretation of coagulation studies<\/li>\n<li>Describe the indications, contraindications and complications of blood products and their administration<\/li>\n<\/ul>\n<p>[\/et_pb_tab][et_pb_tab title=&#8221;Resources&#8221; _builder_version=&#8221;4.27.4&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Overview &amp; Foundational Knowledge<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Zimmerman B &amp; Valentino LA. Hemophilia: In review. <em>Pediatrics in Review<\/em> 2013; 34: 289.<\/strong><\/p>\n<p><a href=\"https:\/\/doi.org\/10.1542\/pir.34-7-289\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/doi.org\/10.1542\/pir.34-7-289<\/a><\/p>\n<p><em>Good review and foundational knowledge. Reviews clotting cascades.<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>The medical assessment of bruising in suspected child maltreatment cases: A clinical perspective.<\/strong><\/p>\n<p><a href=\"http:\/\/www.cps.ca\/documents\/position\/medical-assessment-of-bruising\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/www.cps.ca\/documents\/position\/medical-assessment-of-bruising<\/a><\/p>\n<p><a href=\"http:\/\/www.cps.ca\/fr\/documents\/position\/evaluation-medicale-des-ecchymoses\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/www.cps.ca\/fr\/documents\/position\/evaluation-medicale-des-ecchymoses<\/a><\/p>\n<p><em>Canadian Pediatric Society Practice Guideline (2013).&nbsp;Good tables, differential diagnoses.<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Hutter JJ. Childhood leukemia.&nbsp; <em>Pediatrics in Review<\/em> 2010; 31(6): 234-240.<\/strong><\/p>\n<p><a href=\"https:\/\/doi.org\/10.1542\/pir.31-6-234\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/doi.org\/10.1542\/pir.31-6-234<\/a><\/p>\n<p><em>Very scientific and comprehensive. Note: ANNL = AML.<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div><\/p>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Clinical Resources<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Diagnosis and management of typical, newly diagnosed primary immune thrombocytopenia (ITP) of childhood<\/strong><\/p>\n<p><a href=\"https:\/\/cps.ca\/en\/documents\/position\/immune-thrombocytopenia\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/en\/documents\/position\/immune-thrombocytopenia<\/a><\/p>\n<p><em>Canadian Paediatric Society Practice Point<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Approach to Thrombocytopenia<\/strong><\/p>\n<p><a href=\"https:\/\/www.pedscases.com\/approach-thrombocytopenia\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.pedscases.com\/approach-thrombocytopenia<\/a><\/p>\n<p><em>This PedsCases Note provides a one-page infographic on an approach to thrombocytopenia, <\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Virtual Patients or Cases<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Peds Cases Bleeding and Bruising Part 1<\/strong><\/p>\n<p><a href=\"https:\/\/www.pedscases.com\/approach-bleeding-and-bruising-part-1\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.pedscases.com\/approach-bleeding-and-bruising-part-1<\/a><\/p>\n<p><em>This podcast will highlight an approach to bleeding and bruising in pediatric patients (1\/2)<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Peds Cases Bleeding and Bruising Part 2<\/strong><\/p>\n<p><a href=\"https:\/\/www.pedscases.com\/approach-bleeding-and-bruising-part-2\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.pedscases.com\/approach-bleeding-and-bruising-part-2<\/a><\/p>\n<p><em>This podcast will highlight an approach to bleeding and bruising in pediatric patients (2\/2)<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Approach to Acute Leukemia in Children<\/strong><\/p>\n<p><a href=\"https:\/\/www.pedscases.com\/approach-acute-leukemia-children\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.pedscases.com\/approach-acute-leukemia-children<\/a><\/p>\n<p><em>This episode presents an approach to acute leukemia in children.<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Cards<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Bruising \/ Bleeding<\/strong><\/p>\n<p><a href=\"https:\/\/cards.ucalgary.ca\/deck\/115\" target=\"_blank\" rel=\"noopener noreferrer\">Bruising \/ Bleeding<\/a><\/p>\n<p><em>Canuc-Paeds physician authored, replayable cases<\/em><\/td>\n<\/tr>\n<tr>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>[\/et_pb_tab][\/et_pb_tabs][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; _builder_version=&#8221;3.19.9&#8243; background_color=&#8221;#eeeeee&#8221; global_module=&#8221;2263&#8243; collapsed=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header text_orientation=&#8221;center&#8221; logo_image_url=&#8221;https:\/\/www.pupdoc.ca\/wp-content\/uploads\/2018\/12\/canuc-paeds.png&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;rgba(255, 255, 255, 0)&#8221; background_layout=&#8221;light&#8221; max_width_tablet=&#8221;50px&#8221; custom_padding=&#8221;7px|0px|0px|0px&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; custom_css_main_element=&#8221;max-height: max-content;&#8221; global_colors_info=&#8221;{}&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_one_letter_spacing__hover_enabled=&#8221;off&#8221; button_two_letter_spacing__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221;][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#ffffff&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_3,1_3,1_3&#8243; _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; custom_margin=&#8221;||0px|&#8221; custom_margin_tablet=&#8221;&#8221; custom_margin_phone=&#8221;&#8221; custom_margin_last_edited=&#8221;on|tablet&#8221; custom_padding=&#8221;||0px|&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;||0px|&#8221; custom_padding_tablet=&#8221;||0px|&#8221; custom_padding_phone=&#8221;||0px|&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px|&#8221; custom_margin_tablet=&#8221;&#8221; custom_margin_phone=&#8221;&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; custom_padding=&#8221;||0px|&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/abdominal-pain-abdominal-mass\/\">Abdominal Pain &amp; Abdominal Mass<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/acutely-ill-child\/\">Acutely Ill Child<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/adolescent-health-issues\/\">Adolescent Health Issues<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/altered-loc\/\">Altered Level of Consciousness<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/bruising-bleeding\/\"><strong>Bruising \/ Bleeding<\/strong><\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/dehydration\/\">Dehydration<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/development-behavioural-learning-problems\/\">Development \/ Behavioural \/ Learning Problems<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/diarrhea\/\">Diarrhea<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/edema\/\">Edema<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/eye-issues\/\">Eye Issues<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;||0px|&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px|&#8221; custom_padding=&#8221;||0px|&#8221; custom_css_main_element=&#8221;margin-bottom: 0px !important;&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/fever\/\">Fever<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/genitourinary-complaints\/\">Genitourinary Complaints<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/growth-problems\/\">Growth Problems<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/headache\/\">Headache<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/inadequately-explained-injury\/\">Inadequately explained injury<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/limp-extremity-pain\/\">Limp \/ Extremity Pain<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/lymphadenopathy\/\">Lymphadenopathy<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/mental-health-concerns\/\">Mental Health Concerns<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/murmur\/\">Murmur<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/neonatal-jaundice\/\">Neonatal Jaundice<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/newborn\/\">Newborn<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/pallor-anemia\/\">Pallor \/ Anemia<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/rash\/\">Rash<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/respiratory-distress-cough\/\">Respiratory distress \/ Cough<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/seizure-paroxysmal-event\/\">Seizure \/ Paroxysmal event<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/sore-ear\/\">Sore Ear<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/sore-throat-sore-mouth\/\">Sore Throat \/ Sore Mouth<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/vomiting\/\">Vomiting<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/well-child-care\/\">Well Child Care<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hemophilia Idiopathic thrombocytopenic purpura Leukemia Describe the mechanism of hemostasis: platelet plug formation, coagulation cascade and clot stabilization Demonstrate an approach to the interpretation of coagulation studies Describe the indications, contraindications and complications of blood products and their administration <div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Overview &amp; Foundational Knowledge<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><\/div>\n\t\t\t\t<\/div> Zimmerman B &amp; Valentino LA. Hemophilia: In review. Pediatrics in Review [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-176","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/176","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/comments?post=176"}],"version-history":[{"count":15,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/176\/revisions"}],"predecessor-version":[{"id":2978,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/176\/revisions\/2978"}],"wp:attachment":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/media?parent=176"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}