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Tips and Recommendations

What Are Bleeding Disorders?

“Bleeding disorder” is a general term for a wide range of medical problems that lead to poor blood clotting and prolonged bleeding. Each bleeding disorder has its own range of severity, which is generally categorized as mild, moderate, or severe. Approximately 20,000 individuals in the United States have hemophilia and up to 1% - 2% of the population has von Willebrand Disease (VWD), the most common type of bleeding disorder. Each of these disorders can result in excessive bleeding and each can be treated.

There are variations in severity and types of bleeding disorders. It is important to talk specifically to your student and to his or her parents to gain personal insight.

Here are some possible questions:

Are Bleeding Disorders Dangerous to Me or Other Students?

Bleeding disorders are not dangerous or infectious. A common myth is that someone with hemophilia can die from a paper cut, but that is not true. While you should always use universal precautions, bleeding disorders are hereditary or occur as spontaneous mutations. They are not contagious.

What Can I Do to Make Students and Parents Feel More Comfortable?

  1. Meet with the student, his or her parents, and the school nurse. Possible questions to ask the parents:
    • What do I need to know about your child’s bleeding disorder?
    • Does you child have any food allergies, require any special medications, or have any other special needs?
    • What signs do I look for in your child that might signal a bleed?
    • What should I do if your child has a bleed during class?
    • Under what circumstances should I contact you?
    • What should I do in case of an emergency? When should I call 911?
    • Are there any activities he or she should not take part in?
    • Will he or she be missing a lot of school?
    • How will the work be made up?
    • Do you have an Individualized Health Plan (IHP) on file, including a 504 plan and an Individualized Education Plan (IEP)?
    • What is your insurance company and who is the policy holder in case of an emergency?
  2. Possible questions to ask the student:
    • What do you think I should know about your bleeding disorder?
    • Do you feel comfortable telling your classmates about your bleeding disorder?
    • How would you like me to respond if someone in class asks about your bleeding disorder?
    • Are there things that other people say that you don’t like? I will be careful not to say them and remind your classmates that that is not acceptable.

Remember, they just want to fit in as much as everyone else. Having a brief conversation with them, at any age, is important. Encourage the student to tell you if they have a bleed throughout the school year without causing unnecessary attention.

Have a meeting and discussion with the physical education teacher, or invite him/her to this meeting. Again, it’s important to encourage all students with a bleeding disorder to have a 504 plan in place.

What Do I Do if My Student Has a Bleed?

Each student should have an Individual Health Plan (IHP), and may need a 504 plan or an Individual Education Plan (IEP). Here are some tips from the National Hemophilia Foundation’s First Aid for School Personnel:

How Can I Tell if a Student Is Having a Bleeding Episode?

  • Complains of tingling, bubbling, pain, stiffness, or decreased motion in any limb
  • Appears to have a swollen body part
  • Appears to favor an arm or leg more than usual
  • Limps or refuses to use a limb

Encourage your student to tell you if they think they are having a bleed. If you think they are, contact the parents for instructions, keep the child still to avoid further injury, and apply an ice pack and elevate the body part. Your student might limp after a bleed, it is important to talk to them and their parents about the signs and symptoms. Unwanted or unnecessary attention could cause them to feel uncomfortable.

Remember: For external bleeds, practice universal precautions, as you would with all students.

Common Bleeds

  • Mouth
    • Apply ice with pressure for 20 minutes.
    • Apply a wet tea bag wrapped in gauze.
    • Call the parents for instructions if the bleeding hasn’t stopped after 20 minutes.
  • Nose
    • Position the child sitting straight up with the head upright.
    • Pinch the bridge of the nose using firm continuous pressure for 20 minutes.
    • Apply a cold pack to the back of the neck.
    • Call parents for instructions if the bleeding hasn’t stopped after 20 minutes.
  • Lacerations/External Bleeding
    • Clean the scrape or laceration with an antiseptic soap.
    • Apply firm pressure and elevate the body part until it stops bleeding.
    • Apply a sterile dressing.
    • Apply an ice pack to the area over the bandage.
    • Call parents if the bleeding does not stop after 20 minutes.

Life Threatening Bleeds

If a child suffers a blow to their back, head, and abdomen or has a broken bone or a bleed that will not stop with direct pressure:

  • Contact the parents immediately
  • Contact the hemophilia treatment center if the parents can’t be reached
  • If you cannot reach the parents, nurse, or doctor, you should immediately call an ambulance and transport the child to the designated hospital emergency room.


  • Believe her if she tells you she’s having excessive bleeding.
  • Offer assistance if you can.
  • Allow her to contact her parents.
  • Check out the Bleeding Disorders in Women section of Steps for Living for tips you can offer her for next time.

For more information and a brochure with this information, please request the First Aid for School Personnel from HANDI, NHF's Information Resource Center

HANDI Phone: (800) 42-HANDI

HANDI Fax: (212) 328-3799

HANDI Email: [email protected]