Emergency Principles for Massive Hemoptysis

Massive hemoptysis is defined as expectorating more than 100ml of blood in one episode or over 400ml within 24 hours. This condition poses a significant risk, particularly the potential for airway obstruction and subsequent suffocation. Therefore, it's essential to follow specific emergency principles when managing such cases.

Immediate Patient Stabilization

Staying calm is crucial for both the patient and the caregiver. Anxiety can exacerbate the situation, so providing reassurance and keeping the patient relaxed is vital. If the source of bleeding cannot be determined, positioning the patient in a semi-upright or inclined position can help reduce aspiration risk. However, if the bleeding side is known, placing the patient in a lateral decubitus position with the affected side down can help localize the bleeding and prevent blood from entering the healthy lung.

Medical Intervention and Treatment Options

Pharmacological therapy is often the first line of treatment. For patients without a history of coronary heart disease or hypertension, vasopressin (pitressin) is commonly administered to reduce bleeding. This medication helps constrict blood vessels and control hemorrhage. However, if pharmacological treatment does not yield satisfactory results, more advanced interventional procedures may be necessary.

Advanced Hemostatic Procedures

Minimally invasive techniques have proven highly effective in managing massive hemoptysis. One such method is bronchial artery embolization (BAE), which involves blocking the bleeding vessel using specialized materials. This procedure not only offers faster bleeding control but also significantly improves patient outcomes compared to traditional methods. It is especially beneficial for patients who do not respond well to medication or who experience recurrent episodes of hemoptysis.