Bleeding time is a medical test to evaluate platelet function and blood clotting. The Duke and Ivy methods are used, with the latter being more common. Medications can affect results, and abnormal results can indicate conditions such as thrombocytopenia and von Willebrand disease.
Bleeding time is a medical test performed to evaluate the efficiency of a patient’s platelet function and his body’s blood clotting mechanism. In general, a doctor will use an automatic device to administer a small cut into the patient’s body to produce a small amount of bleeding, and the individual’s bleeding time is the time it takes for the wound to stop bleeding completely. The Duke method and the Ivy method are the two main approaches to performing this test, the latter being the more common of the two. While the Duke method involves pricking the patient with a needle or similar device, the Ivy method is relatively more invasive and involves making an incision in the forearm. While some medications can artificially increase bleeding time if taken shortly before the test, abnormal results can indicate conditions such as thrombocytopenia and von Willebrand disease.
The Duke method is less commonly used. After cleaning the area with rubbing alcohol, the doctor will prick the patient’s fingertip or earlobe with a specialized needle or lancet, usually about 0.1 to 3 mm (4 inches) deep. The normal bleeding time for the Duke method is about one to three minutes.
With the Ivy method, the doctor will use a scalpel blade or spring-loaded lancet to create an incision on the patient’s forearm, usually on the underside where there are no visible veins. The standard size for the cut is usually 0.3 inch long (10 mm) and .03 inch deep (1 mm), and a sphygmomanometer, or blood pressure cuff, is placed anywhere over the wound to maintain a standardized level. blood pressure in the veins. A paper towel will be used to clean the area of blood about every 30 seconds until the bleeding has completely stopped. The normal bleeding time for the Ivy method is between two and nine minutes. In all cases, the bleeding must be stopped manually if the patient bleeds for more than 20 minutes.
Several medications can lead to prolonged bleeding times in patients who have taken them shortly before the test. This can include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and antihistamines. A patient should report any medications she is taking to the doctor before having the test, including over-the-counter medications.
Thrombocytopenia refers to an abnormally low platelet count, leading to a reduced ability for the body to clot. The condition can result from a variety of causes, such as medications that can affect platelet production or primary diseases that lead to the destruction or decrease in platelet production. Platelets from patients who have von Willebrand disease have impaired clotting ability due to a deficiency of von Willebrand factor, a protein essential to the platelet adhesion process. Von Willebrand disease is most commonly inherited, but can be acquired as an offshoot of another primary condition in rarer cases.
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