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    Guidelines For The Management of Haemoptysis:: Date Produced: November 2003-11-06 Next Revision: February 2012

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    Joey Ting
    This guideline provides recommendations for managing haemoptysis, or coughing up blood, based on the amount of bleeding and other factors. For large haemoptysis of over 150mls or airway compromise, the priorities are stabilizing the airway, breathing, and circulation. Further assessment with CT scan and consultation with surgeons may be needed to determine if bronchial arterial embolization, surgery, or bronchoscopy is required. For minor haemoptysis under 150mls, investigation is recommended if there is a family history of lung cancer or recurrent episodes, while isolated minor episodes may not require further action.

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    Guidelines For The Management of Haemoptysis:: Date Produced: November 2003-11-06 Next Revision: February 2012

    Uploaded by

    Joey Ting
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    This guideline provides recommendations for managing haemoptysis, or coughing up blood, based on the amount of bleeding and other factors. For large haemoptysis of over 150mls or airway compromise, the priorities are stabilizing the airway, breathing, and circulation. Further assessment with CT scan and consultation with surgeons may be needed to determine if bronchial arterial embolization, surgery, or bronchoscopy is required. For minor haemoptysis under 150mls, investigation is recommended if there is a family history of lung cancer or recurrent episodes, while isolated minor episodes may not require further action.

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    This guideline provides recommendations for managing haemoptysis, or coughing up blood, based on the amount of bleeding and other factors. For large haemoptysis of over 150mls or airway compromise, the priorities are stabilizing the airway, breathing, and circulation. Further assessment with CT scan and consultation with surgeons may be needed to determine if bronchial arterial embolization, surgery, or bronchoscopy is required. For minor haemoptysis under 150mls, investigation is recommended if there is a family history of lung cancer or recurrent episodes, while isolated minor episodes may not require further action.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    28 views3 pages

    Guidelines For The Management of Haemoptysis:: Date Produced: November 2003-11-06 Next Revision: February 2012

    Uploaded by

    Joey Ting
    This guideline provides recommendations for managing haemoptysis, or coughing up blood, based on the amount of bleeding and other factors. For large haemoptysis of over 150mls or airway compromise, the priorities are stabilizing the airway, breathing, and circulation. Further assessment with CT scan and consultation with surgeons may be needed to determine if bronchial arterial embolization, surgery, or bronchoscopy is required. For minor haemoptysis under 150mls, investigation is recommended if there is a family history of lung cancer or recurrent episodes, while isolated minor episodes may not require further action.

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    Guidelines for the management of Haemoptysis:

    Date Produced: Next revision: November 2003-11-06 February 2012

    This guideline is applicable to all patients seen on the EAU/ESSU with haemoptysis. Local Contact: Dr Jane Dewar, Consultant Physician

    This guideline has been registered with the Trust. However, clinical guidelines are guidelines only. The interpretation and application of clinical guidelines will remain the responsibility of the individual clinician. If in doubt, contact a senior colleagu e or expert. Caution is advised when using guidelines after the review date.

    Guidelines for the management of haemoptysis:


    Large Haemoptysis: > 150mls/ airway compromise
    Is the bleed a terminal event? Eg. Is the patient in the terminal stage of lung cancer/chronic lung disease, where attempts at resuscitation would be futile.

    No

    Yes

    Initial Management:

    Palliation Palliate the patient 3-5mg midazolam and 5mg diamorphine. Suction

    Airway Breathing Circulation


    Suction If the patient cannot maintain their airway, intubation . Lie the patient on the same side as lesion/Abnormality on CXR IV access & Volume re placement Bloods for Cross-match, FBC and clotting. Contact Respiratory Physician and thoracic surgeons

    Further Assessment
    CT thorax for anatomical localisation Liaise with radiology and thoracic surgeons to determine best management: bronchial arterial embolisation/ surgery/ bronchoscopy (rigid or flexible) to identify source of bleeding Assume infection in patients with CF/Bronchiectasis and treat aggressively with antibiotics.

    Guidelines for the management of haemoptysis:


    The causes of haemoptysis are diverse, and as such management will differ according to the exact pathology suspected. The following are therefore guidelines, and will need to be tailored to individual patients. only

    Minor Haemoptysis: <150mls

    Minor Haemoptysis

    Isolated

    Recurrent

    CXR Normal Age<40yrs Life-long non-smoker Yes

    No to any

    Family history of Lung Cancer Previous history of cancers involving lung, head, neck or breast Previous exposure to carcinogens eg. Asbestos and radon gas.

    Refer Respiratory Medicine-urgent OPA if well enough to go home-Resp. SPR on call for referrals will organise. If not, transfer Sou/Flem Investigate

    Yes to any

    No

    Exclude other pathologies if suspected from history eg. PE No further action required if isolated haemoptysis of unknown aetiology. Patients must be told to consult their GP if they have a further episode, as this will require further investigation.

    Refer Respiratory Medicine (as above). Investigate: CT thorax and bronchoscopy

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