ABSTRACT
IS THE PATIENT’S LIFE AT RISK? ■ Cough not associated with other comorbidities-rarely life
threatening ■ Potentially life-threatening situations include
▲ Massive hemoptysis->600 mL/24-48 hours or amount sufficient to cause hemodynamic or respiratory compromise • Medical emergency (mortality rate, 38%) • Differential diagnosis: bronchiectasis, bronchogenic
pneumonia, TB, aspergillosis, necrotizing gram-negative pneumonia, endobronchial mass
▲ Pneumothorax
ADDRESSING THE RISK Massive Hemoptysis ■ Determine that blood has originated from the chest and not
the gastrointestinal or upper respiratory tract. ■ Ensure hemodynamic stability. ■ Position the patient semiupright with bleeding side down. ■ Consider emergent pulmonology consultation for emergent
bronchoscopy. ■ Consider emergent radiology consultation for emergent
bronchial artery embolization. ■ Consider chest CT if patient is stabilized. ■ Consider emergent thoracic surgery consultation if emboliza-
tion is not successful. ■ Assess adequacy of airway; admister oxygen.
