by Norma Chew

Created on: November 26, 2008

According to the Journal of the American Academy of Family Physician, in an article on hemoptysis written by Jacob L. Bidwell, M.D. and Robert W. Pachner, M.D."Hemoptysis is the spitting of blood that originated in the lungs or bronchial tubes."The key words in the definition are, "blood that originated in the lungs or bronchial tubes."

The three most important steps in treating hemoptysis are:

Step 1

Stop the bleeding

It is extremely important to assess and evaluate the source of the bleeding and to determine if it is a true hemoptysis or is it coming from another site such as the nasopharynx, sinus or the gastrointestinal tract. So that the source can be targeted and the bleeding stopped. Bleeding originating from the gastrointestinal tract is called hematemisis.

Step 2

Prevent Aspiration

Prevent the patient from aspirating the blood. This is to avoid asphyxiation and airway obstruction.

Step 3

Treat the source or cause of the bleeding.

Assess the degree of bleeding.

Massive bleeding is life threatening and is a medical emergency.

WHAT ARE THE CAUSES OF HEMOPTYSIS?

Common causes of hemoptysis in children are:

Lower respiratory tract infection.

Foreign body aspiration.

Common causes of hemoptysis in adults are:

Acute or chronic bronchitis

Pneumonia

Lung abscess

Cancer of the lung

Tuberculosis

HOW TO DIFFERENTIATE HEMOPTYSIS VS HEMATEMISIS

Characteristics of hemoptysis are:

The sputum appears frothy because it has air in it.

The sputum appears bright red or pink.

There is no nausea or vomiting.

Asphyxia is a possibility.

Characteristics of hematemisis.

The sputum is not frothy.

The sputum appears brown or black in color.

Nausea and vomiting is common with hematemisis.

Asphyxia is a rare occurrence in hematemisis.

TREATMENT

Treatment is based on the source and the degree of bleeding.

A non-massive bleeding situation can be treated in a clinic or doctor's office,.

A massive bleeding situation is a medical emergency and would need intensive care admission, including intubation and administration of intravenous fluids.

History and physical, past medical history, chest X-ray and other acute care measures

will be necessary.

RISK FACTORS

Bear the following risk factors in mind regarding hemoptysis.

Smoking predisposes one to lung cancer and to the possibility of developing hemoptysis.

Chronic obstructive pulmonary disease is another underlying risk factor in developing hemoptysis.

Certain environmental exposures increases one risk to hemoptysis, such as, exposure to: asbestos, nickel and chromium.

It is best to heed the risk factors than to experience the aftermath of a disease that would include hemoptysis.

American Academy of Family Physician Journal

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