Faculty of dentistry

Assessment of Haemostatic
Function
Bleeding & coagulation times
By
Prof/ Samar El Ghotny
Medical physiology department
By the end of this session, students will be able to : :

1. Define and estimate bleeding and coagulation times.

2. Describe the procedure.
3. Know the normal values of bleeding and coagulation
times.
4. Discuss the causes of abnormal results.
 Assessment of haemostatic
function

1. Bleeding time.

2. Coagulation time.
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It is the time that elapses between the formation of small skin cut till
the stoppage of bleeding from this cut

( without the formation of blood clot)

Small  cut 
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When there is a small injury to a blood vessel , vasoconstriction by

serotonin & thromboxane A2 released from platelets and formation
of platelet plug can be enough to stop bleeding from this small injury

So, bleeding time evaluates the first two steps of hemostasis:

Vascular spasm            Platelet plug formation 
So , bleeding time reflects the

“efficiency of platelets”
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 Make a puncture (in ear lobule, forearm or finger tip ) after
sterilization with alcohol .

 Record the time of puncture.

 Blood is wiped away by a filter paper every 30 seconds

without touching or squeezing the wound itself .

 Observe the time when bleeding stops ( i.e. there is no red

blood spot on the paper).
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Bleeding stops 
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2 – 5 minutes

Bleeding time is increased in:

” Thrombocytopenic purpura “

Bleeding time is normal in :

1. Hemophilia
2. Vit K deficiency
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Platelet defect e.g. Purpura
a) Quantitative defect (Thrombocytopenia, i.e decrease no. )

b) Qualitative defect (Thrombocytopathia, i.e decrease function).

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It is the time that elapses between the start of bleeding and formation
of blood clot
So, coagulation time reflects the

“clotting mechanism”
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After sterilization of skin , puncture the finger tip and observe the time.

Withdraw oozing blood and put it on a dry clean slide.

Check the presence of a clot every 30 seconds by observing the

appearance of worm – like thread of fibrin.

Observe the time when the worm – like fibrin thread is seen.
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1 2 3
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5 – 10 minutes
Coagulation time is increased in:

Congenital e.g. Hemophilia (deficiency of factor VIII) .

Acquired e.g. Vitamin K deficiency & liver disease.

Coagulation time is normal in:

Thrombocytopenic purpura.
Coagulation time is prolonged in:

A. Hemophilia.
B. Anemia.
C. Polycythemia.
D. Purpura. A
Purpura is caused by deficiency of:

A. Factor VIII.
B. Prothrombin.
C. Vitamin K.
D. Platelets.