If a person with a bleeding disorder experiences an accidental or self-inflicted injury while in a behavioral-health or substance-use treatment facility, staff may be understandably concerned about bleeding risks — especially because bleeding isn’t always visible. These concerns are valid and manageable with simple first aid and communication.

Facilities are not expected to be experts in care of bleeding disorders. We are simply asking them to implement the same basic response to injury that daycares, schools and camps use:

Basic response to injuries:

1.  Provide first aid (RICE): – Rest – Ice/Immobilize – Compression – Elevation

2. Contact the bleeding disorder treatment team after any injury or suspected injury.

3.  Call 911 in a life-threatening emergency.

According to the National Bleeding Disorders Foundation’s Medical and Scientific Advisory Council (MASAC), Document 289 (approved October 2024):

“Facility staff should contact the person’s bleeding disorder treatment team after any injury or suspected injury to determine whether further assessment, monitoring, or treatment may be appropriate — even when there are no visible signs of bleeding.”

Internal bleeding can occur without external bleeding, so communication with the treatment team is important. Quick consultation helps determine whether treatment or monitoring is needed and provides reassurance to staff.

MASAC also emphasizes that having a bleeding disorder should not prevent someone from being admitted to or continuing in behavioral-health treatment. As long as the person is medically stable and following their treatment plan, they can be safely cared for in a residential or inpatient setting.

The bottom line: injuries in people with bleeding disorders are manageable. The same basic skills used in day-care centers, schools, or summer camps apply here — with the added benefit of expert backup from the bleeding-disorder treatment team.

Reassuring Facilities About Injury Risk and Care

• “I completely understand your team’s concern — it’s natural to worry about bleeding when you’re unfamiliar with these conditions.”

• “The good news is that injuries in people with bleeding disorders are handled with simple first aid, just like in school or camp. The key is rest, ice, compression, elevation — and a quick call to the treatment team.”

• “Even if there’s no visible bleeding, the treatment team is always available to guide you in real time — you’re never on your own.”

• “MASAC’s national recommendation is that fear of possible bleeding should never prevent someone from being admitted or continuing behavioral-health treatment.”

• “If [insert patient name] is medically stable and continuing their treatment plan, their bleeding disorder should not be a barrier to care.”

• “Our treatment team will provide you with a simple Emergency Action Plan so you’ll know exactly what to do in every scenario.”

You can also ask your treatment team:

• “Can you send the facility a stability letter and Emergency Action Plan before admission?”

Send the following to the facility:

• Guidance for Responding to Injuries in Patients with Bleeding Disorders: Personalize this email template to share MASAC guidance on handling injuries in a facility environment.