Abstract
Background: Hemoptysis is classically defined as the expectoration of blood from the airways and can be further classified into massive and non-massive hemoptysis based on the volume of blood produced. Since quantifying the amount of blood that is expectorated is not entirely practical, clinically massive hemoptysis can be determined by presence of measurable parameters such as hemodynamic instability and arterial blood gas values. Standardized management of patients with life-threatening hemoptysis includes ensuring adequate ventilation and hemodynamic stability, establishing intravenous access, and reversing any bleeding diatheses. Due to certain circumstances, deviation from the typical treatment algorithm is essential at times and necessitates a curated plan for the patient. Case Presentation: Here we present a case of a 32-year-old male that presented to the emergency department with recurrent hemoptysis. He exhibited a distressed state with evidence of airway edema, stridor and hoarseness. As he declined intubation, he was ultimately managed with nebulized tranexamic acid which promptly resolved symptomatology. Conclusions: This case report discusses the advantages, as well as the limitations, of nebulized tranexamic acid use along with the circumstances and patient populations it may be most efficacious. This case report should serve as encouragement for further studies on the use of nebulized tranexamic acid so it can be potentially adopted for routine use in life-threatening hemoptysis.