Hi thanks for contacting health care magic... ESR is non specific measures ... It can be elevated in many inflammatory and infective condition as well in tumours. Your physical examination is necessary first... First it could be from tuberculosis e bronchitis or other respiratory pathology. Chest x ray can be done... If suspected TB , sputum examination done for it.... For it AKT given .And for bronchitis antibiotic given.. Vomitted blood could be from liver pathology. So palpate liver and investigate with liver enzymes study and PT plus serum protein. If present then variceal bleeding also can be there. Gastritis sever or bleeding peptic ulcer also can lead bleeding . For above two condition endoscopy needed. Take care