Massive Haemoptysis

Question 1

How many mls would be considered massive haemoptysis?

Answer 1

Question 2

Outline the 3 main investigations that should be done in an emergency presentation of massive haemoptysis.

Answer 2

Question 3

A patient presents with massive haemoptysis, how will you localise the bleeding?

In general, what are the escalations to stop the bleed?

Answer 3

CT angio or Bronchoscopy

1) Reversal of anticoagulants (including heparin)
2) Tranexamic acid
3) Bronchoscopy techniques (Adrenaline injection, Topical thrombin)
4) Balloon catheter tamponade (take to theatre)
5) IR selective bronchial artery embolisation
6) Lobectomy

Question 4

Describe the full management of a patient in the ED with massive haemoptysis, starting from their presentation to the ED.

Answer 4

Question 5

How is heparin reversed in the case of massive haemoptysis?

Answer 5

Withdraw intake
Protamine Sulfate

Question 6

What agents can be used to reverse anticoagulants?

Answer 6