Management of critical bleeding in patients with immune thrombocytopenia

Immune thrombocytopenia (ITP) is a disease that causes low blood platelets and high risk of bleeding. When serious bleeds occur, patients need to go to the Emergency Department (ED) immediately. There is currently no standard way for emergency doctors and other front-line clinicians to treat these ITP bleeding emergencies, and they are often unprepared to deal with them. On one hand, this can cause delays in treatment, with patients ending up with worse clinical outcomes (bleeding or death); on the other hand, this can cause overuse of treatments including intravenous immune globulin (IVIG), which is in critically low supply. For this research project, we will develop a standard guideline for treating ITP bleeding emergencies using rigorous methods and the best available evidence. We have brought together a group of ITP doctors, emergency doctors and nurses, researchers and patients to create this guideline. We will determine the optimal methods of ensuring that our guideline is readily implemented into practice in EDs in Canada. My program of research will pave the way toward improving the health of people with ITP by ensuring that bleeding emergencies are handled optimally, and that IVIG and other blood products are used judiciously.

GUYATT, Gordon

McMaster University

Graduate Fellowship Program

Ontario

$70,000