Category: Critical Care
-If the patient is able to maintain mentation/airway/SpO2/hemodynamics and cough up blood, intubation is not immediately necessary
-If you do intubate, intubate with the largest ETT possibly to faciliate bronchoscopic interventions and clearance of blood
-The CT scan that typically needs to be ordered is a CTA (not CTPA) with IV con
-See if you can find prior/recent imaging in the immediate setting (e.g. pre-existing mass/cavitation on R/L/upper/lower lobes)
-Get these meds ready before the bronchoscopist gets to the bedside to expedite care:
-If the pt's vent suddenly has new high peak pressures or decreased volumes after placement of endobronchial blocker, be concerned that the blocker has migrated
Charya AV, Holden VK, Pickering EM. Management of life-threatening hemoptysis in the ICU. J Thorac Dis. 2021;13(8):5139-5158.