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| ===Buccal Mucosal Bleeding Time=== | | ===Buccal Mucosal Bleeding Time=== |
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| The buccal mucosal bleeding time is a simple test that gives a rapid assessment of platelet function, providing platelet numbers are normal. If platelet numbers are below 50x10<sup>9</sup>/l, this test should not be performed since the results will be affected by thrombocytopenia, making them unreliable. The small wound inflicted may also not stop bleeding easily. | | The buccal mucosal bleeding time is a simple test that gives a rapid assessment of platelet function, providing platelet numbers are normal. If platelet numbers are below 50x10<sup>9</sup>/l, this test should not be performed since the results will be affected by thrombocytopenia, making them unreliable. The small wound inflicted may also not stop bleeding easily. |
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| To perform the BMBT test, a standardised tool producing a uniform incision is used to incise the buccal mucosa of the upper lip<sup>2,3</sup>, and the time between making the incision and the cessation of bleeding is measured<sup>2</sup>. During the procedure the lip should be kept turned outwards, with excess blood being gently absorbed at a site away from the incision, without disturbing clot formation or applying pressure. Normally, bleeding should stop within 3 minutes, and a BMBT of greater than 5 minutes is considered prolonged<sup>2</sup>. | | To perform the BMBT test, a standardised tool producing a uniform incision is used to incise the buccal mucosa of the upper lip<sup>2,3</sup>, and the time between making the incision and the cessation of bleeding is measured<sup>2</sup>. During the procedure the lip should be kept turned outwards, with excess blood being gently absorbed at a site away from the incision, without disturbing clot formation or applying pressure. Normally, bleeding should stop within 3 minutes, and a BMBT of greater than 5 minutes is considered prolonged<sup>2</sup>. |
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− | Acquired platelet function abnormalities are often drug induced, for example by non-steroidal anti-inflammatory drugs<sup>2, 3</sup>, or caused by uraemia. Hereditary defects in platelet function also exist, and von Willebrand's disease is the most common of these. | + | Acquired platelet function abnormalities can be drug induced, for example by non-steroidal anti-inflammatory drugs<sup>2,3</sup>, or can be secondary to uraemia. Hereditary defects in platelet function also exist, and von Willebrand's disease is the most common of these. |
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| The BMBT is influenced by all the aspects of this phase, including vasoconstriction, platelet adherence and plately aggregation. Although this makes BMBT an effective screening test for the vascular/platelet (primary) phase of haemostasis, it also means it is not purely a test for thrombocytopathia, as it is often considered: BMBT depends on an intact vasospastic response and adequate platelet numbers as well as platelet function<sup>3</sup>. BMBT is a fairly crude test, and has been found to be | | The BMBT is influenced by all the aspects of this phase, including vasoconstriction, platelet adherence and plately aggregation. Although this makes BMBT an effective screening test for the vascular/platelet (primary) phase of haemostasis, it also means it is not purely a test for thrombocytopathia, as it is often considered: BMBT depends on an intact vasospastic response and adequate platelet numbers as well as platelet function<sup>3</sup>. BMBT is a fairly crude test, and has been found to be |