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HemoptysisAka: Bloody Sputum

See Also
1. Hemoptysis Causes
Symptoms and signs
1. Frothy Sputum with bright red blood, and alkaline pH
Evaluation: Non-massive Hemoptysis
1. See labs below
2. Step 1: Consider non-lower respiratory cause
  1. Upper respiratory source (e.g. Sinusitis)
  2. Upper Gastrointestinal Bleeding
    1. Coffee grounds with acidic pH
3. Step 2: Imaging
  1. Start with Chest XRay
  2. High resolution chest CT indicated for abnormal XRay
4. Step 3: Bronchoscopy Indications
  1. Non-diagnostic CT
  2. Recurrent Hemoptysis
Evaluation: Massive Hemoptysis
1. See ABC Management
2. Urgent pulmonology consultation
3. Consider cardiothoracic surgery consultation
Labs
1. Complete Blood Count with platelets and differential
2. ProTime (PT)
3. Partial Thromboplastin Time (aPTT)
4. D-Dimer
5. Sputum Cytology
6. Sputum Gram Stain and culture (including AFB)
7. Tuberculin Skin Testing (PPD)
8. HIV Test
9. Erythrocyte Sedimentation Rate
10. Arterial Blood Gas
Differential Diagnosis
1. See Hemoptysis Causes
References
1. Bidwell (2005) Am Fam Physician 72(7):1253
2. Corder (2003) Emerg Med Clin North Am 21:421

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This page was written by Scott Moses, MD, and was last revised 1/26/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.