Bleeding time test

Introduction 

The bleeding time test is a medical test done to observe the time taken for the formation of a blood clot for the bleeding to stop and also to evaluate the platelet’s function. Platelets also called, thrombocytes are colourless blood cells that help in the formation of a blood clot to stop the bleeding and loss of blood for both internal and external injuries. 

Most times a bleeding time test is ordered in the case where the bleeding does not stop from a  small cut, incision or puncture. If there is prolonged bleeding time deviating a lot from the standard values, it indicates that there is a need for in-depth testing to find out the reason. 

Procedure 

The bleeding time test is done in two methods namely the IVY method and the Duke method.

IVY method: It is the common method, in this method the patient’s arm is kept at the level of the heart and the blood pressure band is inflated to 40mmHg. Then the area of the incision is cleaned with alcohol for disinfecting and with the standard device a cut of 10mmHg long and 1mmHg deep is made on the volar forearm, the blood from the cut is blotted twice a minute. The timer is used for accuracy and the time is noted when the bleeding stops after blotting. IVY method is more accurate but has a risk of scarring. The standard time is 3-8 minutes. 

Duke method: In Duke’ method the area of incision is clean with alcohol that is most of the time either fingertip or earlobe, then stab incision (about 3-4mm deep) is made with a lancet, the time is noted as same for the IVY method. Duke’s method is less reliable and has bigger rates of haematoma. 

Before the procedure, the person who is taking the test is advised to tell the doctor about their own medication list including over-the-counter medications, as some drugs can interact with the clotting of blood. The standard time is 2-3 minutes.

Test interpretation

The abnormal deviations may indicate many disorders like

Thrombocytopenia is observed if the platelet count falls below 30,000, there may be many causes for thrombocytopenia some of them are, drug reactions, autoimmune conditions, vitamin deficiencies and haematological malignancies.

Haemophilia is a genetic condition where there is a defect in the platelet function leading to problems in the clothing of blood.

Primary Thrombocythemia is a condition where the bone marrow produces platelets in large number that affects the blood clot formation.

Von Willebrand Disease is a genetic disorder, deficiency in function or quantity of Von Willebrand factor (a platelet aggregation protein) factor is seen. To confirm this condition more modern techniques are to be done like complete blood count, GP-IP Essay.

Disseminated Intravascular Coagulation is a symptom of other critical diseases or conditions like trauma, burns, pregnancy, sepsis, and malignancies. In this condition Thrombocytopenia 

is observed with low amounts of fibrinogen and high INR. 

Glanzmann’s thrombasthenia is an autosomal recessive genetic disorder of fibrinogen binding receptor glycoprotein IIb/IIIa.

Bernard -Soulier Syndrome is an autosomal recessive genetic disorder, it is a rare condition where the platelets are large due to the defect of glycoprotein Ib.

Medication repressing the function of platelets like aspirin, which are antiplatelet agents that inhibit platelet aggregation and secretion, inhibiting the platelet function. 

Preparations for the test

Inform the doctor about the medications including over-the-counter medication along with prescriptions, vitamins, and mineral supplements being taken at the time of the test, as some medications like aspirin may affect the result as they interact with the platelet function for the formation of the blood clots. 

Do not stop the medication unless the doctor advises so.