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Duration of bleeding (by Duca)
Medical expert of the article
Last reviewed: 06.07.2025
Duration of bleeding (according to Duke) is a specific method of assessing the state of the circulatory system, or more precisely, the vessels. Normally, according to this method, the period from the beginning to the cessation of blood loss should not exceed three minutes.
Hemostasis is a very important function, a whole biological complex, which is aimed at timely stopping of blood, so that the body does not lose it beyond the physiological norm. According to the mechanisms of regulation of blood loss, hemostasis is divided into vascular-platelet or primary and secondary, actually coagulation of blood flow.
Duration of bleeding (according to Duke) is an assessment of the state of platelets. If the vascular walls are damaged, then ideally platelets should immediately become active to participate in coagulation – hemocoagulation. Vessels with normal elasticity spasm and become clogged with aggregated platelets (aggregation – sticking, adhesion of cells). Thus, the vessel is closed by a primary, very important formation, which is called a “white thrombus”.
[ How is the test performed?
Often, the duration of bleeding (according to Duque) is performed with a special needle, also called the Frank needle. It consists of a hollow body with a trigger. On one side, the needle has a sleeve for a spring, on the other, a small tip. A needle of this design is very convenient, since the lab technician can adjust the exact depth of the puncture. By pressing the trigger, when the spring straightens, a very small puncture is made. Duque's test involves collecting no more than 1 ml of material, that is, blood. The puncture is made in the finger, most often in the ring finger, or in the earlobe.
Are there any alternative ways to determine bleeding duration?
The duration of bleeding (according to Duke) is not the only method in the modern diagnostic complex. Often, instead of scarifying the lobe of a human ear, lab technicians use more advanced and sensitive methods. Difficulties in venous outflow are artificially provoked - stasis (often using a blood pressure monitoring device), then a puncture is made in the upper zone of the forearm with a scarifier. Drops of blood are blotted with special sterile napkins every 20-30 seconds. Normally, after three minutes on the last napkin, the spots become small, and after another two minutes the bleeding stops.
Nevertheless, the duration of bleeding (according to Duque) as a method tested for a century has a right to exist. Moreover, hundreds of laboratories continue to use this test, and doctors have become accustomed to trusting this method, using calculations to clarify the diagnosis and adjust therapeutic measures.
What indicators are used to assess primary hemostasis?
In addition to determining the duration of bleeding (according to Duke), platelet activity is also assessed using:
- Calculation of platelet count;
- Calculation of specific platelet formula;
- Assessment of adenosine diphosphate (ADP) and platelet aggregation;
- Assessment of the ability of platelets to aggregate with collagen;
- Determination of the ability of platelets to aggregate with adrenaline;
- Coagulation assessments – von Willebrand factor activity.
The method for determining the time at which the blockage of damaged vessels occurs was developed at the beginning of the 20th century by the American scientist and pathologist William Duke. Previously, the sample was taken with a scarifier or a thin needle from the earlobe, and later – from the finger.
How is bleeding duration assessed (according to Duque)?
Normal hemostasis is able to cope with blood loss, especially such microscopic, in two to three minutes. If coagulation is slow, the duration of bleeding (according to Duke) will be longer. This may indicate, against the background of other indicators that deviate from the norm, liver pathologies, hemophilia and other diseases. It should be taken into account that the period that is measured may depend on the area of blood collection - the fingertip or ear.