#paeds See: [RCH haemophilia](https://www.rch.org.au/clinicalguide/guideline_index/Haemophilia/) See also: [[Von Willebrand disease]] > [!key points] > Haemophilia A : Clotting Factor VIII deficiency > Haemophilia B : clotting factor IX def > > **Treatment** > clotting factor replacement (8 for A, 9 for B) > > **points** > ==do not give IM injections== > # Severity |severity| concentration of clotting factor % | features| |---|---|---| |mild | >5-40 | bleeding with major trauma and surgery | |moderate| 1-5| can bleed after minor injury. can go into joints | |severe| <1%| frequent bleeds common, into joints and muscles| # Treatment Rest Ice Compression bandage Elevation Splint avoid NSAIDs - Factor VIII >10% (mild cases) can be Tx with **DDAVP** → releases vWF → transports factor VIIII - DDAVP dose is 0.3 μg/kg in 100 mL saline over no less than 45 minutes - side effects: face flushing, headache - tachyphylaxis develops after three or four doses - antidiuretic properties can last 24 hours, can cause fluid retention and [[hyponatremia]] - More severe cases need factor VIII replacement # Treat bleeding Minor bleed: factors Major bleed more factors # consequences - compartment syndrome - head bleed