Petechiae and bruises only
Epistaxis that stops within 30 minutes
Can usually be discharged home and no treatment required unless there is uncertainty about diagnosis.
Reassure parents – give advice and information leaflet (see below)
Safety Net advice - return to hospital for following:
Epistaxis requiring nasal packing and/or ENT treatment.
Painful oral purpura and/or significant gingival bleeding
Haematuria, passing blood PR, haematemesis, significant menorrhagia with Hb > 80g/L.
Admit to hospital
Discuss management with a haematologist in local hospital prior to treatment if possible
If further treatment besides TXA is required, then
Suspected internal haemorrhage
Significant external haemorrhage with Hb < 80g/L
Admit to hospital and consider HDU or PICU care
Urgent consultation with haematologist in local hospital and with tertiary paediatric haematologist
Dr Michael Roe, Consultant Paediatrician with an interest in non-oncological haematology, UHS
Wessex Paediatric Haematology Network
Date of Approval: