Bleeding Time by Duke's method and Ivy's method | Procedure

BLEEDING TIME= Bleeding time is a medical test that measures how fast small blood vessels in the skin stop bleeding.

Two alternate procedure are:

1. DUKE's METHOD

With the Duke's method, the patient is pricked with a special needle or lancet, preferably on the earlobe[6] or fingertip, after having been swabbed with alcohol. The prick is about 3–4 mm deep. The patient then wipes the blood every 30 seconds with a filter paper. The test ceases when bleeding ceases. The usual time is about 2–5 minutes.
This method is not recommended and cannot be standardized because it can cause a large local hematoma.


2. IVY METHOD

1. The IVY method is the traditional format for this test. While both the IVY and Duke's method require the use of a sphygmomanometer, or blood pressure cuff, the IVY method is more invasive than the Duke method, utilizing an incision on the ventral side of the forearm, whereas the Duke method involves puncture with a lancet or special needle. In the IVY method, the blood pressure cuff is placed on the upper arm and inflated to 40 mmHg. A lancet or scalpel blade is used to make a shallow incision that is 1 millimeter deep on the underside of the forearm.

2. A standard-sized incision is made around 10 mm long and 1 mm deep. The time from when the incision is made until all bleeding has stopped is measured and is called the bleeding time. Every 30 seconds, filter paper or a paper towel is used to draw off the blood.

3. The test is finished when bleeding has stopped.

4. A prolonged bleeding time may be a result from decreased number of thrombocytes or impaired blood vessels. However, the depth of the puncture or incision may be the source of error.

5. Normal values fall between 3 – 10 minutes depending on the method used.
A disadvantage of Ivy's method is closure of puncture wound before stoppage of bleeding