RespiratoryEmergency Medicine
Massive Haemoptysis
Definition: >200–600 mL/24h or any haemodynamic compromise — airway protection, lateralise, urgent CT angiography, bronchial artery embolisation.
Source: BTS / ERS
Step 1 of ~4
info
Initial Resuscitation
ABCDE. Position patient with bleeding lung dependent (lateralise — protects unaffected lung from soiling). High-flow O₂. IV access × 2; bloods (FBC, U&E, group & cross-match 4 units, coag, fibrinogen, ABG). Continuous SpO₂ + cardiac monitoring. Reverse anticoagulation if appropriate. Aspirin/antiplatelets — discuss with cardiology if recently stented; otherwise hold.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Propranolol · Beta-Blocker — Infantile Haemangioma (Airway)
- Indocyanine Green (Intravitreal Chromovitrectomy) · Diagnostic Dye — Vitreoretinal Surgery / ICG Angiography
- Sucralfate (Burns — GI Mucosal Protection) · Cytoprotective Agent — GI Mucosal Protection
- Tenecteplase (TNK-tPA — STEMI/Massive PE) · Fibrin-Specific Thrombolytic (Third-Generation tPA)
Pathways
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only. Always apply local guidelines and clinical judgement.