Hemostasis, Epistaxis, and Hemorrhage: Definitions and Relationships
Hemostasis = physiologic process that stops bleeding (vascular spasm → platelet plug → coagulation → fibrinolysis).
Epistaxis = nosebleed (bleeding from nasal mucosa).
Hemorrhage = excessive, uncontrolled bleeding (internal or external).
Hemostasis Phases
- Primary: Vasoconstriction + platelet adhesion/aggregation (plug).
- Secondary: Coagulation cascade → fibrin mesh stabilizes plug.
- Fibrinolysis: Plasmin degrades clot after healing.
Clinical Links
- Epistaxis = failure of local hemostasis (Kiesselbach’s plexus).
- Hemorrhage = systemic hemostasis failure (trauma, coagulopathy, anticoagulants).
- Assess: platelet count/function, PT/INR, aPTT, fibrinogen, D-dimer, TEG/ROTEM.
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