Medical assessment of bleeding in the surgical patient.
The key to avoidance of hemostatic failure during surgery is to be able to identify the high-risk patient and make a diagnosis and treat the defect before surgery. A thorough history and physical examination are mandatory in this regard. A screening coagulation profile is not a substitute for the history and physical examination. Selected presurgical tests are useful in major surgical cases and in certain high-risk cases. Otolaryngologists have advised presurgical testing for patients undergoing tonsillectomy, but the subject of presurgical testing is still a matter for investigation in view of the necessity for cost containment. Knowledge of the hemostatic system combined with a knowledge of the tests available to diagnose coagulation defects permits a rational approach to therapy of the bleeding surgical patient.
Messmore
H L
HL
Division of Hematology/Oncology, Loyola University of Chicago, Stritch School of Medicine, Maywood, Illinois.
Godwin
J
J
D001778:Blood Coagulation Disorders / Q000175:diagnosis*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006488:Hemostasis, Surgical; D006801:Humans; D011300:Preoperative Care; D012307:Risk Factors; D013514:Surgical Procedures, Operative