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population being evaluated, making estimation of incidence of disease difficult Table 99.6 provides a differential diagnosis for pulmonary hemorrhage by category Goals of Treatment Management for pulmonary hemorrhage involves support of oxygenation and ventilation and attention to hemodynamics, along with appreciation of the underlying disorder for which other specific therapies may be necessary TABLE 99.6 CAUSES OF PULMONARY HEMORRHAGE IN CHILDREN Clinical Considerations Clinical Recognition Pulmonary hemorrhage results from pathology of lung tissue which can occur in the setting of acute infection such as pneumonia, exacerbation of chronic disease such as CF, or acute localized injury after thoracic trauma Hemoptysis is the most common symptom and finding Patients may have significant respiratory distress and may exhibit signs of hemorrhagic shock Triage Children with pulmonary hemorrhage require prompt assessment as they may present with severe respiratory distress and hemorrhagic shock Initial Assessment/H&P Hemoptysis is the most common presentation of pulmonary hemorrhage It may be necessary to distinguish this from hematemesis or blood from the nose, tonsils,