Describe the bleeding time test and its limitation.
The bleeding time test is a simple bedside test
that evaluates both the quality and quantity of the platelets. A small skin
nick is made with a template on the volar surface of the forearm and the time
until the blood clots is measured. A bleeding time of less than 10 minutes is
considered nor-mal. Anesthesiologists formerly used the bleeding time test to
assess the safety of epidural or spinal anesthesia place-ment. They would only
proceed if the result of the bleeding time test was normal. The bleeding time,
however, is no longer recommended for determining the safety of epidural
catheter placement because it does not necessarily reflect the risk of bleeding
at other sites and there is wide observer variation. In one study, 12 observers
assessed the bleeding time on five separate volunteers. The reliability of the
meas-urements obtained was poor among the 12 observers and the authors
concluded that the test is unreliable.
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