Haemoptysis

Kills by asphyxiation rather than exsanguination
Etiology Chronic inflammatory and malignancy most common
See surgical sieve b
Epidemiology
Pathogenesis bronchial circulation 95%, pulmonary circul
Diagnostic investigations - CXR identifies bleeding point in 43% of cases (Revel et al 2002)
- Gold standard = CT angio with contrast
- Coagulat
Management A-E priorities:
- protect airway ?dual lumen tube etc.
- control breathing; bleeding lung down; PEEP may tamponade
- stabilise haemodynamics
- reverse coagulopathy
- control bleeding at source: bronchoscopy/embolisation
- control bleeding from cause: abx, immunosuppression, etc.

Known bleeding point:
Conservative measures include neb TXA, neb adrenaline
- oint: