Surgical Management of Gastrointestinal Hemorrhage
First Things First (assess & treat for the following)
- Assess magnitude of hemorrhage.
- Stabilize pt.
- 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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