An Approach to the Patient with Non-Surgical Bleeding and a Normal Coagulation Screen

Abstract

In the context of non-surgical bleeding, an initial coagulation screen is useful as a guide to further management. It usually consists of platelet count, prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen level. When the results are normal, underlying coagulation disorders which evade the scope of the initial coagulation screen are suspected. With the knowledge of the principles of the tests used for the initial coagulation screen and the awareness of the rare coagulation disorders which will not affect the initial results, a systematic approach can be applied in the management of such patients. This review aims to highlight the importance of pitfalls in the interpretation of the initial coagulation screening results and provides a brief summary on the coagulation disorders without a deranged initial coagulation screen.