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Anaesthesia · Complications and emergencies: massive haemoptysis
Sample itemA patient with massive haemoptysis from the right lung becomes hypoxic. Which airway strategy best protects the healthy lung?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Isolate the bleeding lung with a double-lumen tube or bronchial blocker and ventilate the other lung
The immediate danger of massive haemoptysis is asphyxia and spillage of blood into the good lung. Lung isolation allows ventilation of the healthy side and controlled management of the bleeding, which may then need bronchoscopic or embolisation treatment.
Option by option
A. Insert a laryngeal mask and allow spontaneous breathing
A supraglottic device does not protect the airway from blood.
B. Use inhalational induction and wait for the cough to clear the blood
Waiting risks asphyxia and does not clear the blood.
C. Isolate the bleeding lung with a double-lumen tube or bronchial blocker and ventilate the other lung (correct)
Correct. Lung isolation protects the healthy lung from soiling.
D. Apply high PEEP through a single-lumen tube to tamponade the bleeding
High PEEP does not control the bleeding and will not protect the good lung.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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