The patient is Mr. TVA (87 years old, Soc Trang province), with symptoms of dry cough for about 2 weeks, coughing more and more frequently. At the same time, the patient coughed up a moderate amount of blood and was hospitalized at Hoan My Cuu Long Hospital.
After one day of monitoring in the intensive care unit, the patient suddenly coughed up a large amount of blood (about 1,000 ml), progressive respiratory failure with mental disorders, sweating, rapid pulse, low blood pressure, and lung failure. bilateral moist rales, rapid shallow breathing, contraction of accessory respiratory muscles.
Determining that the patient was in critical condition, General Department doctors implemented the Code Blue alarm procedure (emergency procedure for patients with cardiac or respiratory arrest) within the hospital, mobilizing emergency departments. . The patient was intubated, mechanically ventilated, vasoactive, and an emergency bronchoscopy team was mobilized to circulate the airway, explore and stop the bleeding.
After 90 minutes of endoscopy, the patient's condition improved. Doctors consulted and agreed on the diagnosis, determining that this was a case of sudden coughing up blood, recurring many times on the basis of bronchiectasis and tuberculosis sequelae, with indications for intervention to evaluate pulmonary embolism. The patient was transferred to the digital subtraction angiography (DSA) room for intervention to treat partial occlusion of the pulmonary apex vessels on both sides.
After 10 days of treatment, the patient stopped coughing up blood and his vital signs were stable, so he was discharged from the hospital and followed up for outpatient follow-up examinations.
Master, Doctor Le Trong Nhan - Department of General Medicine, Hoan My Cuu Long Hospital - said that coughing up blood at lightning speed is a condition that develops suddenly and quickly, causing blood to vomit massively and uncontrollably. .
Specialist Doctor 2 Nguyen Thi Thu Thao - Deputy Head of General Department, Hoan My Cuu Long Hospital - said that the patient in the above case was saved thanks to timely medical resuscitation and airway clearance. emergency bronchoscopy and early endovascular intervention. This is also a miracle in clinical practice, because hemoptysis is very severe and the death rate is almost 100% due to acute airway obstruction despite timely emergency treatment.
According to Dr. Thao, when there are signs of coughing up blood, no matter how much or how little, the patient needs to be immediately transferred to a medical facility for appropriate and timely treatment.
