Hereditary coagulation factor deficiencies
A general practitioner should be aware of the existence of all the patients in his/her area who have severe coagulation factor deficiencies, and these patients’ lifelong haemorrhagic diathesis should be taken into account in all care provided. Rapid initial treatment is essential in suspected bleeding. Therefore, the clotting factor infusion is first given either at home, at a primary care health centre or at a local hospital, and the possible need for further treatment is considered only after that. Especially patients with severe haemophilia and those who have developed clotting factor antibodies are every now and then seen by the haemostasis unit of a tertiary level hospital for the assessment of their condition and for the outlining of subsequent management. Even in mild bleeding disorders, the preparation for any surgical procedure will require preplanning. Aspirin should not be prescribed to patients with bleeding disorders. The analgesic of choice is paracetamol or a combination of paracetamol and codeine. Etoricoxib seems not to increase bleeding tendency and is thus suitable for treating joint pain in a number of patients. Patients should carry a medical alert card with information regarding the diagnosis, the severity of the condition and the clotting factor product or any other medicine required for their particular condition.