How to deal with coughing up blood from the lungs

If the patient is coughing up blood from the lungs, special care must be taken in the treatment of the patient. Generally, patients with heavy bleeding should be allowed to rest in bed, lie on their side under the guidance of a doctor, or use some medications correctly to stop the bleeding.

?1. Patients with severe hemoptysis are required to stay in bed and rest. Medical staff should guide patients to lie on the affected side and provide explanations to eliminate their tension and fear. During hemoptysis, unnecessary movement should be reduced as much as possible to avoid aggravating bleeding due to bumps on the way and causing suffocation and death. At the same time, patients should be encouraged to cough up old blood retained in the respiratory tract to avoid airway obstruction and atelectasis.

2. If the patient is overly nervous, a small dose of sedatives can be used, such as diazepam 2.5 mg, taken orally, twice a day, or diazepam injection 10 mg, injected intramuscularly. For those with frequent or severe coughing, antitussive drugs can be given, such as pentoxyverine 25 mg, orally, 3 times a day; or eprazone 40 mg, orally, 3 times a day. If necessary, codeine 15-30 mg can be given orally, 3 times/d. However, cough suppressants should not be taken by elderly and frail patients. Morphine and pethidine are prohibited for patients with impaired lung function to avoid suppressing the cough reflex and causing suffocation.

3. Drug hemostasis: Posterior pituitary hormone: It can directly act on vascular smooth muscle and has a strong vasoconstriction effect. After taking the medicine, due to the contraction of the pulmonary arterioles, the blood flow in the lungs decreases sharply and the pulmonary circulation pressure decreases, which is conducive to the formation of blood clots at the ruptured pulmonary blood vessels and achieves the purpose of hemostasis. Specific usage: 5-10U of posterior pituitary hormone in 20-40ml of 25% glucose solution, slowly injected intravenously (10-15min injection); or 10-20U of posterior pituitary hormone in 250-500ml of 5% glucose solution, intravenous drip. Repeat once every 6 to 8 hours if necessary. During medication, if the patient experiences side effects such as headache, pale complexion, sweating, palpitations, chest tightness, abdominal pain, urge to defecate, and increased blood pressure, care should be taken to slow down the rate of intravenous injection or drip. It should be used with caution or not at all in patients with hypertension, coronary heart disease, arteriosclerosis, cor pulmonale, heart failure or during pregnancy.

4. Vasodilators: By dilating pulmonary blood vessels, they reduce pulmonary artery pressure, pulmonary wedge pressure and pulmonary wedge impaction pressure; at the same time, systemic vascular resistance decreases, the amount of blood returning to the heart decreases, and the blood in the lungs is diverted to the limbs and visceral circulation, playing the role of "internal bloodletting". This causes the pressure in the pulmonary artery and bronchial artery to decrease, thus achieving the purpose of hemostasis. It is especially suitable for patients with hypertension, coronary heart disease, cor pulmonale and pregnancy who have contraindications to the use of posterior pituitary hormone.