coughing and spitting of blood as a result of bleeding from any part of the respiratory tract. In true hemoptysis the sputum is bright red and frothy with air bubbles; it must not be confused with the dark red or black color of
hematemesis.
Although recent developments in drug therapy have reduced the incidence of serious bleeding in tuberculous patients,
tuberculosis remains a common cause of hemoptysis. Other causes may be bronchitis, bronchiectasis, lung abscess, or malignancy. In acute pneumonia the sputum may be bright red or it may contain old blood which gives it a characteristic rusty appearance. Vascular disorders such as
congestive heart failure and pulmonary infarction can also cause hemoptysis.
Patient care includes placing the affected lung in the dependent position and keeping the airway free of blood either by coughing or suctioning. Although violent coughing is not desirable, the patient can be instructed to cough with the glottis open and without straining. Selective bronchial intubation, bronchial embolization, or surgery may be required if bleeding persists.