How seriously you should take your injuries depends on several factors, including how severe your ITP is in general, how high your platelet count is currently, and how bad your injury is. Depending on these factors, the best response to an injury may range from slapping on a bandage to calling for paramedics. Because of this, the items you should have on hand to deal with ITP-related injuries vary from person to person. Some staples, such as bandages and gauze, apply to everyone, but other treatments — topical or oral drugs, for instance — only apply to some people who have ITP. Here are some things you should consider including in your ITP emergency kit, which you keep nearby at all times.
1. Bandages and gauze
For minor wounds, it’s a good idea to have bandages of assorted sizes and gauze pads with adhesive. “Like anybody else, you’re going to have minor cuts,” notes Claudia Tellez, MD, a hematologist and oncologist at Northwestern Medicine in Chicago. “Not every cut is going to be a hemorrhage that requires calling the paramedics.” For people who have ITP, a minor cut might bleed longer than in other people, but this doesn’t mean it’s a problem, as long as not much blood is lost overall and the bleeding eventually stops, says Dr. Tellez. When you put on a bandage or gauze pad, it’s important to apply pressure for as long as it takes to help stop the bleeding, Tellez notes. It’s worth noting that for most people who have ITP, a simple cleaning is enough for a minor wound. “Somebody with ITP isn’t necessarily at increased risk for infection just because you bleed longer,” explains Tellez. “You don’t necessarily need unusual cleaning solutions or topical antibiotics.”
3. Compress
A compress is an elastic bandage that can be used to apply pressure to a wound by wrapping it somewhat tightly around the affected limb. It’s generally applied after cleaning the wound and applying a bandage or gauze. But a compress can also be useful without an underlying bandage if you experience bleeding under your skin, or a hematoma — a collection of clotted blood outside your blood vessels. “The best first aid for anything like that is always compression,” says Terry B. Gernsheimer, MD, a hematologist and professor of medicine and hematology at University of Washington Medicine in Seattle. Dr. Gernsheimer notes that if you experience a hematoma or any other significant form of internal bleeding, you should follow up your first aid with prompt medical attention, as well as any other self-administered treatments your doctor recommends.
4. Ice pack
Applying an ice pack can be a good way to reduce the inflammation that usually comes with cuts and bruises, and it may improve healing in some situations. “Inflammation can be quite damaging” in the context of a wound, says Tellez. As the healing process runs its course, “A lot of swelling and redness comes from inflammation, and an ice pack can slow that down or prevent it.” It’s important not to apply an ice pack directly to your skin, unless it’s the type of product that has a built-in barrier to ensure it’s not too cold. Instead, you should wrap the ice pack in a thin cloth and periodically rearrange its position on your skin. For an emergency kit you can take with you, include an instant ice pack, which becomes cold when you activate it according to the instructions.
5. Antifibrinolytic drugs
For some people who have moderate to severe ITP, applying pressure may not be enough to stop out-of-control bleeding from an external or internal injury. If you fall into this category, your doctor may prescribe an oral antifibrinolytic drug, which helps stabilize your clotting. “In our body we have a clotting cascade, and we have the fibrinolytic system that breaks down clots,” explains Tellez. “If you block the fibrinolytic system, whatever clot the body made lasts longer.” You should take an oral antifibrinolytic drug according to your doctor’s instructions. In addition to flesh wounds, situations in which you may be advised to take this drug include nosebleeds and very heavy menstrual periods. In addition to oral antifibrinolytics, topical versions that can be applied directly to a wound are available.
6. Tylenol (acetaminophen)
If you injure yourself, you may also be looking for pain relief. For people who have ITP, the best choice in over-the-counter pain relievers is Tylenol (acetaminophen), as it doesn’t inhibit blood clotting. Tellez notes that other common pain relievers, including aspirin and Advil (ibuprofen), have anti-clotting effects that may be harmful to people who have ITP.
7. Medical alert jewelry or cards
In case you experience a severe injury or other medical emergency, it’s critical that paramedics and other medical personnel know that you have ITP. To do this, you’ll need to wear a medical alert bracelet or necklace, or some other kind of identification tag. “I think either people should have a card in their wallet that says what they have and whom to contact, or if they’re not someone who has a wallet on their body at all times, they should wear a bracelet, tag, or necklace,” Gernsheimer advises. Even if you have a medical alert tag or jewelry on you, it’s a good idea to make sure the people close to you know to tell first responders about your ITP in the event of an emergency. “It’s the first thing they should tell the paramedics when they come,” says Tellez. “Medical professionals will react totally differently with that information.”
