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Questions

 36-year-old man with mild haemophilia A attends the Emergency Department with persistent oral bleeding several hours after a dental extraction. He feels anxious but denies dizziness, chest pain, or shortness of breath. He is alert and speaking in full sentences.

Observations are: temperature 36.8°C, heart rate 86 beats per minute, blood pressure 128/76 mmHg, respiratory rate 16 breaths per minute, and oxygen saturation 99% on air.

The registrar is not sure what is suitable as initial treatment. On review of his records, you note that he has chronic heart failure with reduced ejection fraction and takes regular loop diuretics. He has no haematuria and no features of airway compromise.

According to RCEM Best Practice Guideline: Management of Patients with Haemophilia in Emergency Departments (January 2026), what is the single best management?

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