I am basically looking for some information re pulmonary hemorrhages and different ways to treat them. I will preface this by saying I work in a pediatric CICU. I had a 51 year old pt the other day, unrepaired hypoplastic right heart. Hadn't had a cath in years pulmonary blood flow unable to be seen clearly on echo so I really don't know how she was getting blood to her lungs (lots of collaterals I'm sure).
In any case she presented with a pulmonary hemorrhage and I was the lucky on to care for her. First I'll say I was TERRIFIED. I have cared for already intubated infants with pulm hem. and while messy, not to bad, but I was so afraid that this woman was going to just crump on me. In the first 45 minutes of my shift she coughed up over a LITER of frank blood (in addition to the 500cc she'd done on night shift about an hour before). All we were doing to treat was oxygen and robitussin with codeine (oh and platelets & blood transfusions). It did work, she stopped coughing, thank god! and didn't crump on me. I think the plan is for her to eventually get a cath to figure out where the bleeding is coming from (since this was her 3rd admission for it) but what else can be done for these patients? The whole time she was coughing I felt useless, I kept getting her wet washcloths to wipe her face/mouth and making sure she had oxygen but there was nothing I could do to stop the active bleeding and I've never experienced an adult with a pulmonary hemorrhage so I really wasn't sure what to do.
Would love to hear about others experiences with this!