If referring, please give a concise clinical history outlining when the bleeding occurred, any contributing factors, medication etc.
Please see details of medication which can cause unexplained bleeding under ‘who not to refer’.
C.M & L.W 31-07-23
Who to refer:
Please refer individuals with:
- Unexpected and significant bruising or bleeding, spontaneous or provoked (eg trauma, surgery)
- Family history of a bleeding tendency/ disorder
- Significant menorrhagia from menarche
Who not to refer:
- Patients with site-specific bleeding e.g. gastrointestinal, genitourinary, epistaxis may be more appropriately referred to the relevant specialty first.
- Minor increase in bruising after starting drug with known antiplatelet action, e.g. aspirin, clopidogrel, fluoxetine.
- Menorrhagia after teenage years as sole bleeding manifestation: refer to gynaecology first
- If restricted diet and increased bruising / minor oral bleeding only, give trial of vitamin C replacement as per BNF before referring.
How to refer:
SCI gateway to the Department of Haematology RIE.
Primary care investigations
FBC and blood film
Coagulation screen
LFTs, U&Es, thyroid function tests
Protein electrophoresis and urine Bence-Jones protein if >40 years old.
