Clinical Pathways
Clinical Pathways
Traumatic hyphema
Traumatic hyphema

Traumatic hyphema

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Action

  • Elevate the head of the bed (Class II) 
  • Obtain an emergent ophthalmology consult (Class III)

Decision

Does the patient have sickle cell trait/disease?

Yes/Unsure

  • High risk, admit (Class II)

No

  • Family history or concerns for bleeding disorders
  • Check complete blood cell count and obtain coagulation studies
  • Consider factor replacement and admit (Class II)

Background

Children with sickle cell trait or disease are especially at risk for secondary hemorrhage. Some case reports have shown patients with hemophilia are at higher risk for rebleeds as well. Consider checking a complete blood cell count, coagulation studies, and hemoglobin S quantification in cases in which the history is unclear or unavailable.

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References
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