Outline the principles of management of a patient with life threatening haemoptysis.
a) Protection of airway
b) ETT & Adequate ventilation, consider double lumen tube if site of bleeding known
c) Positioning of patient: Trendelenburg position may allow clearance of blood from airway or if the site of bleeding is known, rt or lt lateral position to keep the bleeding lung dependant
SEARCH FOR CAUSES –
Infections, Tumours, Mitral valve disease, Trauma, pulm vasc disorders, vasculitis, bleeding diatheses
H/o and Clinical examination – upper and lower respiratory
Bleeding and coagulation profiles
1) Volume replacement
2) Bronchoscopy - ablation of lesions
3) arterial embolisation
UpToDate has a nice summary of massive hemoptysis
Shigemura, Norihisa, et al. "Multidisciplinary management of life-threatening massive hemoptysis: a 10-year experience." The Annals of thoracic surgery87.3 (2009): 849-853.
Reechaipichitkul, Wipa, and Sirikan Latong. "Etiology and treatment outcomes of massive hemoptysis." (2005).