A 58-year-old man with known bronchiectasis presents with 300 mL haemoptysis over two hours. He is pale, RR 30/min, SpO2 90% on 15 L/min oxygen and

Question

A 58-year-old man with known bronchiectasis presents with 300 mL haemoptysis over two hours. He is pale, RR 30/min, SpO2 90% on 15 L/min oxygen and BP 98/62 mmHg. Chest radiograph shows right lower-zone bronchiectatic change but no pneumothorax. What is the most important immediate action?

Accepted Answer

Protect the airway, position bleeding side down and involve respiratory, anaesthetic and interventional radiology teams urgently

Answer

Place the patient flat with the bleeding side up

Answer

Start anticoagulation for presumed pulmonary embolism

Answer

Give oral tranexamic acid and discharge

Answer

Arrange outpatient bronchoscopy within two weeks

Massive haemoptysis — SCE Acute Medicine MCQ

A 58-year-old man with known bronchiectasis presents with 300 mL haemoptysis over two hours. He is pale, RR 30/min, SpO2 90% on 15 L/min oxygen and BP 98/62 mmHg. Chest radiograph shows right lower-zone bronchiectatic change but no pneumothorax. What is the most important immediate action?