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Detection and Diagnosis of Hemorrhagic States

Armand J. Quick, PhD, MD
JAMA. 1966;197(6):418-420. doi:10.1001/jama.1966.03110060092025.
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Bleeding conditions are common but are often missed or ignored because serious hemorrhage occurs only occasionally and usually can be managed and controlled by transfusion of blood or plasma. There has been, nevertheless, a growing demand to detect bleeders, and attempts have been made to devise a screening test for this purpose. Because hemostasis is a complex physiological process, the prospect of finding one single test to establish defective hemostasis is remote. Fortunately, it is possible to achieve this goal fairly satisfactorily by a combination of four simple tests: bleeding, clotting, prothrombin, and prothrombin consumption times. Even mild bleeding states can be detected and usually definitively diagnosed. Each of the tests requires a minimum of skill and no special equipment, thereby making this battery of procedures available to hospitals with limited laboratory facilities. It is the purpose of this presentation to point out the clinical application and interpretation of the


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