title: ED visits by males with hemophilia.
abstract: Hemophilia is a rare disorder affecting 1 in 5,000 males. Because hemophilia-associated hemorrhage may occur at anytime, affected males frequently seek care in the ED. We studied the epidemiology of ED visits by males with hemophilia. The medical records of all identified Coloradan males with hemophilia who sought care in Colorado EDs in 1998 were reviewed. Fifty-one males with hemophilia had a total of 125 ED visits; hemorrhage accounted for 64.8% of visits (95% CI=55.6, 73.1). On 13.0% (95% CI=6.4, 22.6) of visits for hemorrhage, treatment was warranted, but not given. On 12.3% (95% CI=5.5, 22.8) of visits when treatment was given, there were errors in product choice or dose. Documentation of factor concentrate brand and lot number was present for just 13.9% (95% CI=6.5, 24.7) and 24.6% (95% CI=14.8, 36.9) of visits, respectively. There is substantial room for improvement in the prescribing practices and documentation related to hemophilia care in the ED. Available resources should be utilized by ED physicians.
authors.affiliation: Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Health Sciences Center and the Colorado Department of Public Health and Environment, Denver, CO, USA. rachelle.nuss@uchsc.edu
authors.forename: Rachelle
authors.initials: R
authors.lastname: Nuss
authors.forename: Richard
authors.initials: R
authors.lastname: Hoffman
authors.forename: Lucinda
authors.initials: L
authors.lastname: Hammond
mesh_terms: D000328:Adult; D001780:Blood Coagulation Tests / Q000706:statistics & numerical data; D003120:Colorado / Q000453:epidemiology; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D004282:Documentation / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006467:Hemophilia A / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008485:Medical Audit; D008499:Medical Records / Q000592:standards; D008508:Medication Errors / Q000706:statistics & numerical data
chemical_list: D006490:Hemostatics; D003894:Deamino Arginine Vasopressin