🩸 Section 458.2 · Pulmonary Hemorrhage and Hemoptysis

Nelson Textbook of Pediatrics 22nd Edition | Hemoptysis: expectoration of blood from lower respiratory tract. Causes: infection (bronchitis, pneumonia, TB, bronchiectasis, lung abscess), foreign body, pulmonary embolism, vasculitis (GPA, Goodpasture), idiopathic pulmonary hemosiderosis (IPH), Heiner syndrome (cow's milk), mitral stenosis, coagulopathy, trauma, arteriovenous malformation (HHT). Diagnostic approach: CXR, CT, bronchoscopy, BAL (hemosiderin-laden macrophages). Management: treat underlying cause, supportive care (oxygen, airway protection). Massive hemoptysis (>240 mL/24h or >8 mL/kg): secure airway, lateral decubitus (bleeding side down), bronchial artery embolization, surgery.

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📋 30 Clinical Scenarios — Pulmonary Hemorrhage & Hemoptysis

📇 High‑Yield Cards: Pulmonary Hemorrhage & Hemoptysis (Chap 458.2)

🩺 Interactive Clinical Approach: Hemoptysis & Pulmonary Hemorrhage

Select a presentation for diagnostic and management approach.

📋 Stepwise Management of Hemoptysis & Pulmonary Hemorrhage

    SeverityDefinitionManagement
    MildBlood-streaked sputum, <20 mL/dayOutpatient workup (CXR, CT, bronchoscopy), treat underlying cause
    Moderate20-240 mL/dayAdmit, monitoring, bronchoscopy, treat cause
    Massive>240 mL/24h or >8 mL/kg or life-threateningAirway protection (intubation), lateral decubitus (bleeding side down), bronchial artery embolization, surgery

    ⚡ Reflex Prompts — Hemoptysis Recognition & Management

    📖 Summary: Pulmonary Hemorrhage & Hemoptysis — Nelson 22nd Ed

    Source: Nelson Textbook of Pediatrics 22nd Ed — Section 458.2. Hemoptysis in children is often from infection or bronchiectasis. Massive hemoptysis requires airway protection and bronchial artery embolization.