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.

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Last updated: May 5, 2010