Bleeding Time Overview

• Bleeding Time is a screening test for disorder of platelets function, both congenital and acquired: useful in the diagnosis of Von Willebrand’s disease. Thrombocytopenia or aspirin therapy prolongs the bleeding time.
• General interpretations of bleeding time are as follows:
  • 1-9 minutes: Normal
  • 9-15 minutes: Platelet dysfunction
  • More than 15 minutes: Critical; test must be discontinued and pressure should be applied
  There is two methods used to determine Bleeding Time:

  Ivy method

  • This is the most commonly used method.

  • A blood pressure cuff is applied to the arm and inflated to 40 mm Hg. The patient’s forearm is then cleaned with alcohol, and an incision is made with a sterile blade or scalpel, 1 mm deep and 10 mm long. Since the test is directed to capillary vessels, the area should have no large vessels.

  • Immediately, a stopwatch starts recording time. Then, every 30 seconds, a filter paper is applied gently over the wound. Whenever the paper absorbs blood, it means that the bleeding is active and has not stopped. This is repeated every 30 seconds until the bleeding stops completely (ie, no more blood is being absorbed by the filter). After the bleeding stops, the blood pressure cuff should be deflated. The bleeding time is defined as the time from the incision until all bleeding has stopped.

  • Duke method

    • This technique is similar to the Ivy method; however, no blood pressure cuff is needed. In addition, it is less invasive, since it involves making a puncture wound that is 3 mm deep after the area is cleaned with alcohol. Areas with no large vessels are preferred, such as earlobe. Then, with a filter paper, the wound is swabbed every 30 seconds until no more blood is absorbed.
    • Although the Ivy method is more invasive, it is preferable, since its results are more reproducible.