I have had many hemoptysis episodes over the past year, not just pink in sputum but many clots that were scary to view the first time it happened. The clots were large and dark red, like maroon, ranging from specks to an inch in size. The coughing covered about 10 minutes so it wasn't just a one cough event. Each time I went to the ER but the fifth time I went the on-duty physician said, after viewing the pictures I had taken, that even though the clots looked scary, it wasn't necessary to go to the ER each time. My episodes were scattered and not pure blood; more like dried blood that had accumulated. These episodes are just part of bronchiectasis (and in my case MAC too).

Each time I have an episode, I take pictures, which I would suggest you do also. Sometimes I've spent hours in the ER when it wasn't necessary. I spent Labor Day weekend in the hospital because the doctors wanted me to have a bronchoscopy but they don't do bronchoscopies on holiday weekends so they kept me until Tuesday, which wasn't what I had in mind for a Labor Day weekend.

Most doctors say that if you are coughing up pure blood of a tablespoon or more that it may indicate a pulmonary embolism and an ER visit would be necessary. I won't be going to the ER anytime soon unless I'm scared I may have an embolism.