Coagulation

Coagulation laboratory tests

Bleeding time



Topic Completed: 1 June 2012

Minor changes: 14 September 2020

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Bleeding time [title]

Jeremy C. Parsons, M.D.
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Cite this page: Parsons JC. Bleeding time. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/coagulationbleedingtime.html. Accessed October 18th, 2021.
Definition / general
  • A relatively nonspecific and nonsensitive test of platelet function, whose use is declining
  • This test should usually be avoided, particularly if definitive testing, such as a von Willebrand panel is available
  • Preoperative bleeding time does NOT predict surgical bleeding
  • Test is affected by use of aspirin or other NSAIDs, patients should abstain from their use for 1 week prior to testing
  • Test is also affected by how incision is made (very difficult to standardize)

  • Procedure:
    • Place blood pressure cuff on arm at 40 mm Hg
    • Then trained technologist makes a small incision on patients arm, blots the blood gently every 30 seconds with filter paper, without touching the clot, to see if bleeding has stopped and records the time when it stops
    • Then apply bandage

  • Duke bleeding time:
    • Uses earlobe or fingertip pierced with lancet

  • Ivy bleeding time:
    • Blood pressure cuff at 40 mm Hg on arm, and forearm cut by lancet

  • Mielke (template) bleeding time:
    • Template placed on skin with spring loaded blade that cuts through template, to standardize the size and depth of cut
    • More reproducible than standard bleeding time but still quite variable

  • Reference range:
    • Varies, sample range is 1.5 - 9.5 minutes (less in newborns)

  • Prolonged values:
    • Platelet count less than 100K, low hemoglobin, use of aspirin or other platelet inhibitors
    • Also von Willebrands and other hereditary platelet disorders, uremia

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