Use only after discussing with hematology attending. Use only after discussing with hematology attending. Check with the hemophilia program staff. Stimate must be ordered by name, it is the only effective intranasal formulation. It is recommended that prophylaxis begin after a child has established a pattern of repeated bleeding but before frequent joint bleeds occur.
Intention is to prevent joint bleeding.
If hospitalized, discharge at 24-36 hours if studies and examination remain normal. Always err on the side of caution in determining the treatment plan for patients with head trauma. Children with severe hemophilia and a history of intracranial bleeding should be considered a candidate for prophylaxis. However, even children on prophylaxis should receive replacement therapy if they have significant head trauma. Children with tongue or neck swelling must always be evaluated for possibility of airway obstruction.