History: An 85-year-old woman suffered a fall, as a result of which she fractured her left neck of femur and was admitted to the orthopaedic ward. She underwent a successful operation. Since her medical history included hypertension and chronic renal impairment, her team were aware that low-molecular-weight heparin should be avoided; hence heparin was used postoperatively to prevent thrombus formation.
Four days later the patient is complaining of a nosebleed that does not seem to be stopping. Investigations: Blood count at admission: Parameters Identified Normal range White cells 9 4–11 x 10 9 /L Haemoglobin 8 13–18 g/dL Platelets 350 150–400 x 10 9 /L Repeat…
