Surgical Management of Gastrointestinal Hemorrhage

First Things First (assess & treat for the following)

• Assess magnitude of hemorrhage.
• Stabilize pt.
  • ABCs
  • Two large-bore IVs
  • Begin resuscitation w/ crystalloid solution (lactated Ringer’s).
  • Follow w/ blood if required after 2 L of crystalloid.
  • Place Foley catheter.
  • Place NG tube to help differentiate upper & lower GI bleeding. Lavage the stomach w/ saline until clear fluids returns. Return of bilious material suggests bleeding beyond ligament of Treitz.