The emergency department evaluation and management of massive hemoptysis
| Autor: | Brit Long, Elliot D. Backer, Matthew A. Roginski, Colman J. Hatton, Skyler Lentz, Patricia Ruth A. Atchinson |
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| Rok vydání: | 2021 |
| Předmět: |
Diagnostic Imaging
Hemoptysis medicine.medical_specialty Resuscitation medicine.diagnostic_test business.industry medicine.medical_treatment Interventional radiology General Medicine Emergency department medicine.artery Emergency Medicine Humans Medicine Intubation Airway management Embolization Emergency Service Hospital business Airway Bronchial artery Intensive care medicine |
| Zdroj: | The American Journal of Emergency Medicine. 50:148-155 |
| ISSN: | 0735-6757 |
| Popis: | Introduction Massive hemoptysis is a life-threatening emergency that requires rapid evaluation and management. Recognition of this deadly condition, knowledge of the initial resuscitation and diagnostic evaluation, and communication with consultants capable of definitive management are key to successful treatment. Objective The objective of this narrative review is to provide an evidence-based review on the management of massive hemoptysis for the emergency clinician. Discussion Rapid diagnosis and management of life-threatening hemoptysis is key to patient survival. The majority of cases arise from the bronchial arterial system, which is under systemic blood pressure. Initial management includes patient and airway stabilization, reversal of coagulopathy, and identification of the source of bleeding using computed tomography angiogram. Bronchial artery embolization with interventional radiology has become the mainstay of treatment; however, unstable patients may require advanced bronchoscopic procedures to treat or temporize while additional information and treatment can be directed at the underlying pathology. Conclusion Massive hemoptysis is a life-threatening condition that emergency clinicians must be prepared to manage. Emergency clinicians should focus their management on immediate resuscitation, airway preservation often including intubation and isolation of the non-bleeding lung, and coordination of definitive management with available consultants including interventional radiology, interventional pulmonology, and thoracic surgery. |
| Databáze: | OpenAIRE |
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