“Hemoptysis is coughing up blood that originates from the respiratory tract below the level of the larynx. The causes of hemoptysis vary from simple bronchitis to life-threatening pulmonary embolism.”1
“Hemoptysis results from disruption of blood vessels within the walls of the airways, from trachea to bronchi, bronchioles, and the lung parenchyma.”2. When hemoptysis is suspected it is important to determine if the source of bleeding is actually coming from a pulmonary source and exclude epistaxis and hematemesis, in order to focus on the key principles and management.
Priorities in the evaluation of hemoptysis are:1
- Ensuring adequate oxygenation and ventilation
- Confirming a pulmonary source of bleeding
- Attempting to identify the cause of hemoptysis through appropriate diagnostic evaluation
- May include CXR, bronchoscopy, and/or CT chest.
- Appropriate disposition
Click HERE for a list of all mentioned FOAM resources.
- Young, W. F., Chapter 66, “Hemoptysis”. Tintinalli’s Emergency Medicine – A Comprehensive Study Guide. J Tintinalli. 7th ed. McGraw-Hill Education, 2010.
- Sims, T., Chapter 63, “Hemoptysis”. Tintinalli’s Emergency Medicine – A Comprehensive Study Guide. J Tintinalli. 8th ed. McGraw-Hill Education, 2016.
Prepared by Alex Mungham PGY1 FM – University of Ottawa