Coughing up blood: what should you know?

Blood may arise from irritated gums, the nose or throat and then appear during coughing, or from the lower airways. Forceful coughing can irritate small airway vessels. Acute Bronchitis and Bronchiectasis can present with blood-streaked mucus; asthma and other airway problems may also need consideration. Bright red blood, clots, repeated episodes, or blood mixed through mucus deserve careful attention. Vomited blood often looks different and may be accompanied by nausea or abdominal discomfort, so describe exactly what happened.

Stop strenuous activity, sit upright and note the colour, amount and number of episodes. Do not suppress the symptom with leftover medicine, and do not take aspirin or an anti-inflammatory specifically for this problem unless a clinician has advised it. Contact a clinician promptly for any unexplained blood, even if it stops. Bring a list of medicines, including blood thinners, and mention smoking, recent infection, nosebleeds and chest symptoms.

Call emergency services for a large or continuing amount of blood, clots, severe breathlessness, chest pain, faintness, confusion, blue lips or a very fast heartbeat. Seek same-day assessment for repeated blood-streaked mucus, fever, worsening cough, or new shortness of breath. Do not drive yourself if you feel faint or are struggling to breathe.

Ask where the blood is most likely coming from, whether your medicines increase bleeding, whether you need chest imaging or other tests, and what changes should trigger emergency care.