Hemoptysis resident survival guide: Difference between revisions
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{{familytree | G01 | | G02 | | | | | | G03 | G01= '''Mild hemoptysis'''<br> <30 cc in 24Hr | G02= '''Moderate hemoptysis''' <br> 30-200 cc in 24Hr| G03= '''Massive hemotysis''' <br> 200- 600cc or more in 48Hr <br> or/and <br> Sings and symptoms of hypovolemia }} <ref> name="pmid12243312">{{cite journal| author=Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B| title=Hemoptysis: a retrospective analysis of 108 cases. | journal=Respir Med | year= 2002 | volume= 96 | issue= 9 | pages= 677-80 | pmid=12243312 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12243312 }} </ref> | {{familytree | G01 | | G02 | | | | | | G03 | G01= '''Mild hemoptysis'''<br> <30 cc in 24Hr | G02= '''Moderate hemoptysis''' <br> 30-200 cc in 24Hr| G03= '''Massive hemotysis''' <br> 200- 600cc or more in 48Hr <br> or/and <br> Sings and symptoms of hypovolemia }} <ref> name="pmid12243312">{{cite journal| author=Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B| title=Hemoptysis: a retrospective analysis of 108 cases. | journal=Respir Med | year= 2002 | volume= 96 | issue= 9 | pages= 677-80 | pmid=12243312 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12243312 }} </ref> | ||
{{familytree | |!| | | |!| | | | | | | |!| }} | {{familytree | |!| | | |!| | | | | | | |!| }} | ||
{{familytree | |!| | | |!| | | | | | | G04 | G04= ❑ Secure airway permeability <br> O negative blood type transfusion}} | {{familytree | |!| | | |!| | | | | | | G04 | G04= ❑ Secure airway permeability <br> ❑ O negative blood type transfusion}} | ||
{{familytree | |!| | | |!| | | | | | | |!| }} | {{familytree | |!| | | |!| | | | | | | |!| }} | ||
{{familytree | H01 | | H02 | | | | | | H03 | | H01= Treat underlying disease | H02= CT | H03= Bronchoscopy }} | {{familytree | H01 | | H02 | | | | | | H03 | | H01= Treat underlying disease | H02= CT | H03= Bronchoscopy }} | ||
Revision as of 20:13, 27 January 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Definition
Hemoptysis is the expectoration of blood from the respiratory system.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Hemoptysis may be a life-threatening condition depending on the severity of bleeding and must be treated as such irrespective of the causes.
Common Causes
- Pulmonary disease
- Cardiovascular disease
- Pulmonary artery arteriovenous malformation
- Pulmonary embolism
- pulmonary hypertension
- Bronchial artery aneurysm
- Thoracic aortic aneurysm
- Aortobronchial fistula
- Others
- Coagulopathy
- Von Willebrand disease
- Haemophilia
- Trombocytopenia
- Iatrogenic
- Anticoagulation
- Trauma
- Coagulopathy
Management
[3][4]| Characterise the symptoms ❑ Coughing up blood ❑ Chest pain ❑ Tachypnea ❑ Dyspnea | |||||||||||||||||||||||||||||||||||
| Examine the patient ❑ Inspection of nasopharynx and oropharynx to exclude hemorrhagic sites from Nasopharynx or gastrointestinal track ❑ Vital signs and oxygen saturation ❑ Respiratory rate ❑ Accessory respiratory muscles use | |||||||||||||||||||||||||||||||||||
| ❑ UGI bleed ❑ NP bleed | |||||||||||||||||||||||||||||||||||
| Order lab ❑ Complete blood count ❑ Arterial blood gas ❑ Coagulation profile ❑ Electrolites ❑ Blood typing and cross match | |||||||||||||||||||||||||||||||||||
| Stable patient | Unstable patient | ||||||||||||||||||||||||||||||||||
| Chest radiography | |||||||||||||||||||||||||||||||||||
| Mild hemoptysis <30 cc in 24Hr | Moderate hemoptysis 30-200 cc in 24Hr | Massive hemotysis 200- 600cc or more in 48Hr or/and Sings and symptoms of hypovolemia | |||||||||||||||||||||||||||||||||
| ❑ Secure airway permeability ❑ O negative blood type transfusion | |||||||||||||||||||||||||||||||||||
| Treat underlying disease | CT | Bronchoscopy | |||||||||||||||||||||||||||||||||
| Diagnose found | Diagnose not found | Location of bleeding found | Location of bleeding not found | ||||||||||||||||||||||||||||||||
| Treat underlying disease | Bronchoscopy | Endobronchial tamponade | Arteriography | ||||||||||||||||||||||||||||||||
| Find location of bleeding | CT | Bronchial artery embolization | |||||||||||||||||||||||||||||||||
| Treat the cause | Treat the cause | ||||||||||||||||||||||||||||||||||
Do's
Dont's
References
- ↑ name="pmid20058006">Chun JY, Morgan R, Belli AM (2010). "Radiological management of hemoptysis: a comprehensive review of diagnostic imaging and bronchial arterial embolization". Cardiovasc Intervent Radiol. 33 (2): 240–50. doi:10.1007/s00270-009-9788-z. PMID 20058006.
- ↑ name="pmid10834728">Jean-Baptiste E (2000). "Clinical assessment and management of massive hemoptysis". Crit Care Med. 28 (5): 1642–7. PMID 10834728.
- ↑ name="pmid10834728">Jean-Baptiste E (2000). "Clinical assessment and management of massive hemoptysis". Crit Care Med. 28 (5): 1642–7. PMID 10834728.
- ↑ name="pmid12243312">Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B (2002). "Hemoptysis: a retrospective analysis of 108 cases". Respir Med. 96 (9): 677–80. PMID 12243312.