Massive Hemoptysis - Diagnosis and Management
• Definitions:
- Hemoptysis = bleeding from below vocal cords
- Pseudo-hemoptysis = upper respiratory tract (e.g. epistaxis) or Gl bleeding (mimics hemoptysis)
- Massive hemoptysis = life threatening bleeding, not necessarily defined by the amount (100-1000ml) or rate of bleeding (>1OO ml/hr) but has potential to cause death by asphyxia or blood loss.
• Workup
• General Management
• Airway Management and Positioning
• Bleeding Localization and Interventions
• Bronchoscopic Interventions
- Cold Saline (50 Cc Ns Boluses)
- Epinephrine
- Topical TXA (500 - 1000 Mg)
- Bronchial Blockers
- Ablation, Cautery, Cryo
- Argon Plasma
by Nick Mark MD @nickmmark and Mark Ramzy, DO, EMT-P @MRamzyDO
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