Teachers & Daycare
What you should know about hemophilia
Normally, when people injure themselves, their blood clots in a few minutes. This stops the bleeding, and helps the wound heal. The blood is able to clot because it has proteins called clotting factors. A person with hemophilia is missing, or has too little, clotting factors. Without enough clotting factor, the blood cannot clot properly after an injury.
It’s a common myth that people with hemophilia bleed more, or bleed more quickly – but this isn’t the case. But, they do bleed for a longer period of time. This can be a serious issue if someone has a large external wound or internal injuries (inside the body). Minor cuts and scrapes are rarely serious.
However, for a child with hemophilia, a seemingly minor bump may continue to bleed internally, creating a painful and slow-healing injury. Over time, repeated joint bleeding can weaken and damage the joint. The most dangerous internal bleeds occur in the brain, neck, chest, or major organs—these can be life threatening and require immediate medical attention. Bleeds are most commonly treated with clotting factor infusions that replace the clotting factor that is missing, but other treatments may also be used. Factor infusions are used in patients who are appropriate candidates. Some patients receive infusions regularly to help prevent bleeds.
Understanding what causes hemophilia, its symptoms, potential risks for bleeds, and how to treat a bleed are important when caring for a young child or student with hemophilia. Explore this site to learn more about hemophilia and its treatment.
What you can do: First steps
As a teacher, coach or daycare provider, there a few steps you need to take to support a child with hemophilia. Rest assured that you will receive support and guidance from the child's parents and Hemophilia Treatment Centre (HTC).
Learn about hemophilia, its symptoms, how it’s treated, and activities that may put a child at risk for a bleed in the setting where you care for them.
- If you care for a child in a daycare setting, you know how active and eager to explore they are. Falls and injuries happen – no matter how hard you try to watch over them. Get tips for creating a safe space
- In the school setting – especially as children become more involved in sports and other physical activities – it’s important to help kids choose the right activities, and take the necessary precautions to minimize the risk for injury. Two resources can guide you: Hemophilia: What School Personnel Should Know and The Playing it Safe: Bleeding Disorders, Sports & Exercise Guide.
Work with parents to understand the limitations hemophilia puts on their child and which activities pose a higher risk.
- Coaches, in particular, should pay close attention to injuries in practice or during games, and work to ensure safe play by all. Parents and healthcare providers can help determine what kind of safeguards, like protective equipment, may be necessary. Click here for School Resource Guides
Learn how to recognize the signs of a bleed, what to do and who to contact if one occurs.
- Depending on your role, you may be asked to provide information for the child’s bleed records and treatment diaries.
- Work with a child’s parents to learn what activities might require a child to get extra infusions in advance, and to confirm with them if they’ve been scheduled.
Guidelines for dealing with bleeding episodes
Here are some important guidelines that may be useful to school personnel and other adults who are regularly involved with a child or teen with hemophilia:
- If the child complains of pain, believe them, even if there is nothing to see.
- Difficulty moving a limb normally, or excessive pain with or without moving, is a symptom of bleeding.
- Be aware that a child might try to hide their symptoms to avoid missing an exciting activity.
- Parents should be the first people consulted if you suspect a bleed. Make sure you always have all the parents' contact information on file (home, work, and cell phone numbers, pager number, etc.).
- The delay between the beginning of a bleed and the treatment must be reduced as much as possible—prompt treatment is crucial.
- Significant trauma to the head, among other injuries, can cause a life-threatening bleed.
- You must not "wait and see"—notify parents and emergency medical staff immediately.
- Basic first aid care can be administered when a bleeding episode happens—remember the key words Rest, Ice, Compression, and Elevation (RICE).
- Treat the child with hemophilia like every other child; avoid treating them in a way that could make them feel different or isolated from the other children.
Creating a safe daycare environment
Caring for newborns or toddlers in a daycare is challenging – as they explore everything around them! It’s important to create a safe and nurturing environment. Here are some points to consider:
- Encourage all staff to learn the basics of hemophilia
- Develop a plan of action for emergencies
- Ensure there is sufficient supervision (staff to child ratio)
- Make necessary safety adjustments (e.g. eliminating any sharp protruding edges, storing scissors after every use)
- Remember to allow a child to explore – just with a few extra precautions
MYTH: People with hemophilia can bleed to death from minor cuts.
FACT: External wounds or cuts are usually not serious. But, internal bleeding can be serious. Internal bleeding can occur in the joints (especially the knees, ankles or elbows) and vital organs.
Click here for Resources