Emergency Medicine Cases
Ep 188 Hemoptysis – ED Approach and Management
Nov 7, 2023
Learn about the key principles and approach to managing hemoptysis in the emergency department. Topics include differentiating hemoptysis from pseudohemoptysis, the use of tranexamic acid, suctioning blood from the airway during intubation, the role of bronchoscopy, and how hemorrhage control strategy changes with pulmonary embolism. The podcast also discusses preparations and equipment for managing hemoptysis, the utility of CT scans and point-of-care ultrasound, and various strategies for intubation and airway management. Additionally, it covers the importance of reliable suction, alternative options if inadequate, and the approach and interventions for managing hemoptysis.
01:11:04
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Quick takeaways
- Differentiate between upper airway, lower airway, or gastrointestinal sources of bleeding in hemoptysis cases.
- Rapid sequence intubation (RSI) and effective suctioning are crucial in managing massive hemoptysis.
Deep dives
Identifying the Source of Bleeding: Distinguishing Hemoptysis
When dealing with hemoptysis cases, it is important to first determine the source of bleeding. Clinical clues such as a history of coughing before blood appears, the appearance of the blood itself, and observing if there is blood dripping from above can help differentiate between upper airway, lower airway, or gastrointestinal sources of bleeding. A nasopharyngoscopy or video bronchoscopy can provide further visualization of the airway and help identify the bleeding site.
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