R.I.C.E. If a bleed does occur begin treatment as quickly as possible as instructed by your doctor. In addition to treatment prescribed by your doctor, it may be helpful to follow R.I.C.E. guidelines to help with pain and swelling. R.I.C.E. is a popular first-aid term for the combination of Rest, Ice, Compression, and Elevation.28 Rest: To make sure that there is no weight or stress put on the affected joint, stop all activity involving that joint until treatment is completed and the bleed appears to be resolving. Ice: Apply ice to the affected joint for about 20 minutes. Make sure there is a barrier (cloth or pad) between the ice and skin to prevent ice burn. Do not keep the ice on for too long. Ten or fifteen minutes at a time, every 2 hours, is long enough. Compression: Apply pressure around the joint by wrapping an elastic bandage around it. Be careful not to wrap too tightly, this could cut off circulation or cause pain. Elevation: Prop the joint up so that it is higher than the heart. This will help decrease the pressure in the blood vessels and will help slow the bleeding. Factor replacement therapy The amount of bleeding expected in an individual with hemophilia depends upon the severity of the factor deficiency. The first course of action when treating a bleed involves intravenous infusion of clotting factor.29 Specific doses, additional drugs and medical interventions depend upon the site and severity of bleeding. An individualized treatment plan will be developed for you by your HTC team.