patient care report hemoptysis example

How are patients with hemoptysis managed?

Patients with hemoptysis should be managed based on the rate and severity of bleeding (massive or nonmassive) and the clinical condition of the patient. In case of massive bleeding in unstable patients, resuscitation is mandatory before any other diagnostic investigation. Massive hemoptysis

What is included in the diagnostic investigation of hemoptysis?

The diagnostic investigation of hemoptysis includes history taking, clinical chemistry, chest radiography, contrast-enhanced multislice computed tomography with CT angiography, and bronchoscopy. The advantages of multislice computed tomography are as follows:

What are the signs and symptoms of hemoptysis?

When in doubt consult ENT for nasolaryngoscopy – this test can be done rapidly and safely at the bedside. Occasional patients may be having severe posterior epistaxis masquerading as hemoptysis; this is essential to recognize rapidly. Coffee-ground appearance. History of vomiting or regurgitation. Triage: who needs ICU?

What is hemoptysis in nursing?

In clinical practice hemoptysis is a common symptom, which may require further investigation. It is defined as the expectoration of blood that originates from the lower respiratory tract (1). Bleeding from the upper airways is excluded from this definition.

How do you take history of hemoptysis?

To determine the likely etiology of hemoptysis, consider the amount of blood expectorated, duration of symptoms, and the patient's age, smoking history, and past medical history. Differentiate between true hemoptysis versus bleeding from the upper airway or gastrointestinal tract.

What investigation would you carry out with a patient that is presenting with hemoptysis?

The diagnostic investigation of hemoptysis includes history taking, clinical chemistry, chest radiography, contrast-enhanced multislice computed tomography with CT angiography, and bronchoscopy. Correct disclosure of the cause of hemoptysis in 60 to 77% of cases (3, 23– 25), e.g., alveolar hemorrhage. bronchiectasis.

What is evaluation of hemoptysis?

Hemoptysis is the expectoration of blood from the lung parenchyma or airways. The initial step in the evaluation is determining the origin of bleeding. Pseudohemoptysis is identified through the history and physical examination.

What is normal hemoptysis?

Hemoptysis is defined as the expectoration of blood from the lung parenchyma or airways. The volume of blood produced has traditionally been used to differentiate between nonmassive and massive hemoptysis; the cutoff value ranges from 100 to 600 mL of blood produced in a 24-hour period.

How is hemoptysis pronounced?

0:010:37How to Pronounce Hemoptysis? (CORRECTLY) Meaning ... - YouTubeYouTubeStart of suggested clipEnd of suggested clipLe king a try to prononce de medical te faut de cofinot of blood au de blood stone de mucus et. SafeMoreLe king a try to prononce de medical te faut de cofinot of blood au de blood stone de mucus et. Safe house du goba planète hip hop this is.

Is hemoptysis a diagnosis?

Hemoptysis is the spitting of blood that originated in the lungs or bronchial tubes. The patient's history should help determine the amount of blood and differentiate between hemoptysis, pseudohemoptysis, and hematemesis. A focused physical examination can lead to the diagnosis in most cases.

How can you tell the difference between hemoptysis and Hematemesis?

The blood in hemoptysis is generally bright red or rust and may be admixed with sputum and frothy. The blood in hematemesis is dark red or brown and may be mixed with food particles. The bleeding in hematemesis is commonly preceded by vomiting or retching.

What are the possible causes of hemoptysis?

Possible CausesBlood clot in the lung.Pulmonary aspiration (breathing blood into the lungs).Lung cancer.Excessive, violent coughing that irritates your throat.Pneumonia.Using blood thinners.Tuberculosis.Pulmonary embolism (blockage of an artery in your lungs).More items...•

How is Haemoptysis treated?

Treatment for hemoptysis depends on how much blood you're coughing up and what's causing it....Hemoptysis TreatmentsA tube that goes into your airways (intubation)Extra oxygen (ventilation)A body position in which the lung with possible bleeding is lower than the other lung.

Is haemoptysis a red flag?

Frothy sputum with bright red blood may suggest haemoptysis. Postnasal drip or epistaxis may suggest pseudohaemoptysis, that is, blood arising from the nasopharynx rather than the respiratory tract. Coffee-ground vomitus is more suggestive of haematemesis.

General principles of hemoptysis

The primary concern is how the patient is doing from a respiratory standpoint (e.g. respiratory rate, saturation), not the patient's hemoglobin level.

Ddx versus pseudohemoptysis

Defined as expectoration of blood originating from the nasopharynx, oropharynx, larynx, or gastrointestinal tract.

Triage: who needs ICU?

This is very vague, because in reality it's often impossible to precisely quantify the volume of hemoptysis.

Roadmap

There are numerous approaches to hemoptysis. This may depend to a certain extent on local resources and practice patterns. This roadmap is intended to provide a general schema for approaching this, but it certainly won't be applicable to every patient.

nebulized tranexamic acid (TXA)

Shown to be beneficial in one RCT which excluded patients with massive hemoptysis. ( 30321510)

Questions & discussion

To keep this page small and fast, questions & discussion about this post can be found on another page here.

What Is a Patient Care Report?

We often hear of care reports based on by medical teams or by medical authorities. Yet, we are not sure how this differs from the kind of report that is given to us by the same people. So this is the time to make it as clear as possible.

How to Write a Patient Care Report?

Where do you even begin when you write a patient care report? A lot of EMS or EMTs do know how to write one since they are trained to do so.

What is a patient care report?

A patient care report is a document made mostly by the EMS or EMTs. This documented report is done after getting the call. This consists of the information necessary for the assessment and evaluation of a patient’s care.

What should not be written in a patient care report?

What should be avoided in a patient care report is making up the information that is not true to the patient. This is why you have to be very careful and very meticulous when writing these kinds of reports. Every detail counts.

Who is in charge of reading the patient care report?

The person or the people who will be reading the report are mostly medical authorities. When you are going to be passing this kind of report, make sure that you have all the information correctly. One wrong information can cause a lot of issues and problems.

THE CASE

A 31-year-old man presented to the emergency department with a history of recurrent episodes of hemoptysis for 1 month after an upper respiratory tract infection. Several weeks after the onset of symptoms, he noted fatigue and dyspnea with mild physical exertion.

DISCUSSION

Our patient presented with a potentially life-threatening pulmonary-renal syndrome characterized by diffuse pulmonary hemorrhage and a rapidly progressive glomerulonephritis. Typically, patients with a form of ANCA-associated small vessel vasculitis have an estimated 2-year mortality rate of 90% without treatment.

Differential diagnosis

The differential diagnosis for pulmonary-renal syndrome is unique to a rare subset of vasculitides and immune complex diseases. The most common causes are categorized into 3 main groups, as defined by the 1994 Chapel Hill nomenclature system. 4

Pathophysiology

While it is clear that ANCAs are associated with the small-vessel vasculitides, the pathophysiology is still a working hypothesis.

Making the diagnosis in our patient

Serological test results were positive for MPO-ANCA (p-ANCA) in our patient, initially suggesting an ANCA-associated small-vessel vasculitis (microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome).

Microscopic polyangiitis

This nongranulomatous, necrotizing small-vessel vasculitis is often characterized by an active glomerulonephritis (80% to 100% of patients) and pulmonary capillaritis (10% to 30% of patients). 3,4 The disease is typically associated with MPO-ANCA (p-ANCA) and a lack of immune deposits on immunofluorescence.

Treatment

A strong suspicion of microscopic polyangiitis warrants early empirical treatment to prevent the development of further irreversible damage and potentially death in severe cases. 7,27 Our patient may have had a poor outcome without early treatment given his pulmonary hemorrhage and advanced renal insufficiency on presentation. 27