Introduction to Hemostasis

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Definition of TermsHistorical Background

Historical Development of Clinical HemostasisThe Hemostasis Laboratory Today

marjisimmeingjamias,rmt


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STOPPAGE of bleeding

Arrest of bleedingBy physiologic properties of vasoconstriction and

coagulation or by surgical meansNormal Hemostasis depends on:

Types of surrounding tissues

Integrity of blood vessels

Normal platelet numberFunction and presence of adequate amounts offunctioning coagulation promoting and inhibitingproteins



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Escape of blood from the vessels into thesurrounding tissue or into the environment



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Purpura

Hemorrhage of blood into small areas of the skin,mucus membranes and other tissues

Areas first appear red but later turn purple andfinally brownish-yellow (conversion of heme tobiliverdin)

As the color fades, biliverdin is converted tobilirubin which is removed form the area andprocessed in the liver



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Ecchymoses

A form of purpura in which blood escapes into largeareas of skin or mucus membranes, but not intodeep tissue

The area turns black and blue (bruise) and later,

greenish brown or yellow



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Petechiae

Purplish red, pinpoint hemorrhagic spots (


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Epistaxis

Nose bleed

Hemoptysis

Expectoration of blood secondary to hemorrhage inthe larynx, trachea, bronchi or lungs



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HematemesisVomiting of blood

Melena

Stool containing dark red/black bloodHemarthrosis

Leakage of blood into the joint cavity

MenorrhagiaExcessive uterine bleeding occurring at the usualintervals of menstruation



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Aristotle and Plato

2nd Century AD

HEMOPHILIA was the first coagulation disorder tobe recognized

5th Century Talmud (Writing)

Two male children were described to have diedfrom excessive bleeding after circumcision



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OTTO (1803)Published clinical descriptions of families withhemophilia

Schnlein

Gave the name hemophilia (love of hemorrhage)

Hopff (1828)

Published a thesis that described the disorder ashemophilia



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Lee and White Whole Blood Coagulation Time

WBCT

1st laboratory test to evaluate the clottingmechanism

Described in 1913

1930sQuick developed the Prothrombin Time Test

1940sFew routine tests for evaluating the hemostaticmechanism

Platelet count, bleeding time, WBCT, PT



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Tests for Coagulation and Fibrinolytic SystemTest reagents

Automated Techniques

Visual Examination of Clot FormationReplaced by mechanical or photo-optical clotdetection

Immunoassays and Spectrophotometric

DeterminationsQuantitation of substances involved inenhancement or inhibition of coagulation orfibrinolysis


Introduction to Hemostasis

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