When Is Coughing Up Blood An Emergency
Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York.
Coughing up blood, otherwise known as hemoptysis, can be very frightening. It can also be confusing at first. Is the blood truly coming from your lungs or could it be from a nosebleed, your esophagus, or from your stomach? While hemoptysis is the most specific symptom of lung cancer, it is more often due to a benign cause.
Lets look at the possible causes, what may be done to diagnose the underlying problem, and the possible treatment options.We will also discuss when coughing up blood can be an emergency, but coughing up even small amounts of blood can be dangerous.
Coughing up a third of a cup of blood has a mortality rate of around 30%. If you have coughed up a teaspoon or more of blood, dont wait to make an appointment. Call 911 now.
Treatment For Chest Infections
Most people with bronchitis can be treated at home and make a full recovery. Assessment of the severity of pneumonia is complex. Some patients can be managed at home on simple antibiotics. Those assessed as severe may require admission to the intensive care unit and their illness may be life threatening.Treatment options include:
- Your doctor will advise you about any medications you need to get over this attack.
- Some people need to be admitted to hospital for further treatment, particularly young children and the elderly who are at greater risk of serious complications.
- Review with your local doctor may be needed within 48 hours, especially if you are not improving, and again in six weeks to make sure that you have made a full recovery. A chest x-ray may be needed at this time.
Other Causes Of Phlegm
Exposure to toxins or chemicals can make you produce more mucus. The lining of the airways become irritated and produce mucus to help clear away the pollutants. Over time smoking can lead to increased mucus production even after quitting smoking.
People with a lung condition, such as chronic obstructive pulmonary disease , may also have darker yellow or green phlegm. This disease is more common with age. And it is especially common in people who smoke cigarettes.
However, there are other chronic diseases that can lead to more mucus production and more coughing up of phlegm such as cystic fibrosis or bronchiectasis.
Not all mucus comes from the lungs. The nasal passages can create mucus. This can happen from a common cold. It can also be from allergies such as hay fever.
When the mucus drips down the back of the throat , it can cause coughing that is sometimes mistaken as phlegm coming from the lungs.
Is it normal to have constant phlegm?
“If youve been living with chronic cough and mucus, talk to your doctor about what may be causing the mucus. There may be easy treatments for the underlying causeand it is important to try and figure out if there is an underlying condition causing the mucus.” Dr. Ranard
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Key Points About Pneumonia
Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi.
There are more than 30 different causes of pneumonia, and theyre grouped by the cause. The main types of pneumonia are bacterial, viral, and mycoplasma pneumonia.
A cough that produces green, yellow, or bloody mucus is the most common symptom of pneumonia. Other symptoms include fever, shaking chills, shortness of breath, low energy, and extreme tiredness.
Pneumonia can often be diagnosed with a thorough history and physical exam. Tests used to look at the lungs, blood tests, and tests done on the sputum you cough up may also be used.
Treatment depends on the type of pneumonia you have. Antibiotics are used for bacterial pneumonia. It may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias dont have a specific treatment and just get better on their own. Other treatment may include a healthy diet, more fluids, rest, oxygen therapy, and medicine for pain, cough, and fever control.
Most people with pneumonia respond well to treatment, but pneumonia can cause serious lung and infection problems. It can even be deadly.
What Are The Complications Of Pneumonia
Anyone can experience complications from pneumonia. However, people in high-risk groups are more likely to develop complications, including:
- Breathing difficulties: Pneumonia can make breathing difficult. Pneumonia plus an existing lung disorder can make breathing even more difficult. Breathing difficulties may require a hospital stay to receive oxygen therapy or breathing and healing assistance with the use of a breathing machine .
- Fluid buildup in the lungs : Pneumonia can cause a buildup in the fluid between the membranes that line the lungs and the inside of the chest cavity. It is a serious condition that makes breathing difficult. Pleural effusion can be treated by draining excess fluid with a catheter, chest tube or by surgery.
- Bacteria in the bloodstream : The bacteria that cause pneumonia can leave your lungs and enter your bloodstream, spreading the infection to other organs. This condition is treated with antibiotics.
- Lung abscess. A lung abscess is a pus-filled cavity in the lung that is caused by a bacterial infection. It can be treated by draining the pus with a long needle or removing it by surgery.
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What Is Coughing Up Blood
Coughing up blood refers to coughing or spitting up of blood or bloody mucus from your respiratory tract . Its a common condition that can have many causes. Some of these conditions can be very serious.
Coughing up blood isnt the same as vomiting blood. Blood thats coughed up often looks bubbly and is mixed with mucus. It can be red or rust colored and is usually in small amounts. Vomiting blood refers to large quantities of blood being expelled from your mouth.
What Are The Signs And Symptoms Of Bacterial Versus Viral Pneumonia In Adults
Symptoms of pneumonia can range from mild sometimes called walking pneumonia to severe. How serious your case of pneumonia depends on the particular germ causing pneumonia, your overall health, and your age.
Bacterial pneumonia: Symptoms of bacterial pneumonia can develop gradually or suddenly. Symptoms include:
- High fever
Additional symptoms appearing about a day later include:
- Higher fever
- Shortness of breath
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If Oxygen Therapy Is Recommended Inogen Can Help
In cases of bronchiectasis, chronic bronchitis, COPD or certain other lung diseases and breathing conditions, oxygen therapy may be prescribed to help make breathing easier and improve your quality of life. Depending on what is causing you to cough up bloody mucus, your doctor may suggest you use supplemental oxygen in conjunction with other medications, treatments or breathing and coughing techniques. If you required emergency care, you may receive supplemental oxygen in the hospital, or have it prescribed for home use. For patients who do not require hospitalization, or for patients who have been released from hospitalization, portable oxygen treatments can significantly improve your breathing so you can still participate in your regular activities. This can go a long way in allowing you to maintain as normal a lifestyle as possible, even with a chronic or debilitating condition.
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What Causes Pneumonia Cough
The cough reflex is your bodys most important weapon against pneumonia. People who cant cough properly are at a higher risk of getting pneumonia in the first place.
You need three things for a cough:
Cough-triggering sensors are in the back of the throat, airways, stomach, diaphragm, and the lining of your heart. Pneumonia cough is mainly triggered by sensors in your upper and lower airways.
When you are suffering from pneumonia, your airways are inflamed. You have increased secretions in your airways caused by the immune system. You also have germs causing the pneumonia and dead cells that need to be replaced. All these things act as triggers for the cough sensors.
The cough reflex happens suddenly, and you cant stop it once it is triggered. Cough sensors activate the cough center in the brain, triggering three events in order:
Compressing air in the second step can produce a very high pressure, similar to that created by water 13 feet deep. The rapid release can blow air as fast as 500 miles per hour. This force can clear away germs and irritants.
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How To Find Relief From Your Wet Cough
Though unpleasant, coughing is actually necessary in order to rid your lungs of mucus. Coughs can, however, become uncomfortable, and when this is the case, there are some ways that you can relieve your symptoms at home.
Home remedies for a wet cough include:
- Drinking plenty of fluids: Staying hydrated helps thin and loosen the mucus in your sinuses and airways, thus making it easier for your body to get rid of when you cough.
- Elevating your head at night: Using an extra pillow or two to elevate your head before going to sleep can help ease a cough by preventing mucus from pooling at the back of your throat.
- Adding moisture to the air: Dry air can aggravate coughs by irritating your throat and airways, so adding moisture to the air by using a humidifier or vaporizer may bring you some relief. Alternatively, you can also choose to run a hot shower and then sit in the steam to soothe your cough.
- Trying cough drops: Cough drops can be a quick and easy way to get some relief from a cough, and these may especially come in handy if you are experiencing coughing attacks or if your symptoms make it hard to fall asleep. Just take care to avoid falling asleep with a cough drop in your mouth, as this is a choking hazard.
What Does Green Or Yellow Phlegm Mean
If you see green or yellow phlegm, its usually a sign that your body is fighting an infection. The color comes from white blood cells. At first, you may notice yellow phlegm that then progresses into green phlegm. The change occurs with the severity and length of the potential sickness.
Green or yellow phlegm is commonly caused by:
Bronchitis: This usually starts off with a dry cough and eventually some clear or white phlegm. Over time, you may start coughing up yellow and green phlegm. This is a sign that the illness may be progressing from viral to bacterial. Coughing can last up to 90 days.
Pneumonia: This is typically a complication of another respiratory issue. With pneumonia, you may cough up phlegm that is yellow, green, or sometimes bloody. Your symptoms will vary based on the type of pneumonia you have. Cough, fever, chills, and shortness of breath are common symptoms with all types of pneumonia.
Sinusitis: This is also known as a sinus infection. A virus, allergies, or even bacteria can cause this condition. When it is caused by bacteria, you may notice yellow or green phlegm, nasal congestion, postnasal drip, and pressure in your sinus cavities.
Cystic fibrosis: This is a chronic lung disease where mucus builds up in the lungs. This disease often affects children and young adults. It can cause a variety of phlegm colors from yellow to green to brown.
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Light Red Blood Streaks In Phlegm
This author has been verfied for credibility and expertise
Phlegm, or sputum, is produced when the lungs are inflamed and excess mucous is produced in the respiratory tract. The medical term for blood in the sputum is hemoptysis. According to MedlinePlus, blood in the sputum differs from bleeding that comes from the mouth, stomach or throat because it contains air bubbles combined with mucous 1. Blood mixed with phlegm could be bright red, rust colored or streaked with red.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
When Should I See My Doctor
You should see a doctor straight away, or go to a hospital emergency department, if:
- you are short of breath
- it hurts to breathe
- you have a very high fever
- you are coughing up a lot of phlegm
- there is blood in the phlegm
- your symptoms are not improving or they are getting worse
- you have a heart or lung disease, such as heart failure or asthma
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How To Regain Your Strength After Pneumonia
While recovering from mild pneumonia, be sure to:
- Eat a well-balanced diet
- Slowly work back into your exercise routine
“Physical activity can help your lungs regain strength but go slow. Start with light exercise and stop if your cough worsens or you have trouble breathing. If a light workout feels okay, you can put a little more effort into your next workout,” says Dr. Lee.
However, Dr. Lee’s advice for someone recovering from severe pneumonia looks quite different.
“The first thing to realize is that your body may be extremely weak after being discharged from the hospital, so you’ll need to take extra care leaning on your support network, if possible,” says Dr. Lee.
Why Does It Take So Long To Recover From Pneumonia
You can’t see the damage pneumonia causes, but you certainly feel it.
The air sacs in your lungs become inflamed during pneumonia, leading to soreness and pain. If the infection and inflammation progress, your lungs may fill with fluid and dead lung tissue, leading to the green, yellow or even bloody mucus you cough up. This fluid may also affect how well oxygen is able to transfer into your bloodstream, leading to difficulty breathing.
“Once the infection is cleared with treatment, your body still has to deal with removing all of the fluid, damage and debris left behind in your lungs. This can take a few weeks, resulting in a lingering cough and reduced lung capacity,” explains Dr. Lee. “During this time, you may find physical exertion more tiring than usual.”
A more severe case of pneumonia can cause even more damage to your lungs, which can be significant and even permanent in some cases.
“After severe pneumonia, lung capacity is reduced and muscles may be weak from being so ill. Significant weight loss can further contribute to weakness and other health conditions may be aggravated due to the stress placed on the body during illness. These are all things your body will need time to recover from,” says Dr. Lee.
In fact, it may take another several months for you to fully heal and regain strength.
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Hemoptysis Diagnosis And Tests
If youâre coughing up blood, your doctor will do one or more of these:
- Medical history andphysical exam. This helps them gather clues to identify the cause.
- Chest X-ray. This can show whether thereâs a mass in your chest or areas of fluid or congestion in your lungs.
- CT scan. With detailed images of the inside of your chest, this test may reveal some causes for coughing up blood.
- Bronchoscopy . Your doctor runs a flexible tube with a camera on its end, called a bronchoscope, through your nose or mouth and into your windpipe and airways.
- Complete blood count . This test checks the number of white and red blood cells in your blood, along with platelets .
- Urinalysis . Some causes of hemoptysis also show up on this simple urine test.
- Blood chemistry profile. This test measures electrolytes and how well your kidneys are working.
- Coagulation tests. Changes to your bloodâs ability to clot, or coagulate, can lead to bleeding and coughing up blood.
- Arterial blood gas. This test measures the levels of oxygen and carbon dioxide in your blood. Oxygen levels can be low in people coughing up blood.
- Pulse oximetry. A probe tests the level of oxygen in your blood.
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Caring For Your Symptoms At Home
Many chest infections aren’t serious and get better within a few days or weeks. You won’t usually need to see your GP, unless your symptoms suggest you have a more serious infection .
While you recover at home, you can improve your symptoms by:
- getting plenty of rest
- drinking lots of fluid to prevent dehydration and to loosen the mucus in your lungs, making it easier to cough up
- treating headaches, fever and aches and pains with painkillers such as paracetamol or ibuprofen
- drinking a warm drink of honey and lemon to relieve a sore throat caused by persistent coughing
- raising your head up with extra pillows while you’re sleeping to make breathing easier
- using an air humidifier or inhaling steam from a bowl of hot water to ease your cough
- stopping smoking
Avoid cough medicines, as there’s little evidence they work. Coughing actually helps you clear the infection more quickly by getting rid of the phlegm from your lungs.
Antibiotics aren’t recommended for many chest infections. They only work if the infection is caused by bacteria, rather than a virus.
Your GP will usually only prescribe antibiotics if they think you have pneumonia, or you’re at risk of complications such as fluid building up around the lungs .
If there’s a flu outbreak in your local area and you’re at risk of serious infection, your GP may also prescribe antiviral medication.
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What Is The Outlook For Pneumonia
People who are otherwise healthy often recover quickly when given prompt and proper care. However, pneumonia is a serious condition and can be life-threatening if left untreated and especially for those individuals at increased risk for pneumonia.
Even patients who have been successfully treated and have fully recovered may face long-term health issues. Children who have recovered from pneumonia have an increased risk of chronic lung diseases. Adults may experience:
- General decline in quality of life for months or years