Medical Management of Gastrointestinal Hemorrhage
First Things First (assess for & treat the following)
- Upper GI bleed (UGIB), proximal to ligament of Treitz (LT); lower GI bleed (LGIB), distal to LT
- Airway protection
- Consider endotracheal intubation in a pt w/ massive UGI bleeding, especially if he/she has altered mental status; massive bleeds are more commonly seen in variceal bleeding.
- Circulation
- Assess hemodynamic status and intravascular volume (i.e., orthostatic, tachycardia, cool-clammy skin, etc.)
- Hypotension is a late finding in shock. Never underestimate the magnitude of the GI blood loss.
- Establish two large-bore peripheral lines, or central access if unable to obtain adequate peripheral access.
- Resuscitate using crystalloids, blood and its components with correction of coagulopathy.
- Assess hemodynamic status and intravascular volume (i.e., orthostatic, tachycardia, cool-clammy skin, etc.)
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Last updated: May 10, 2010
Citation
"Medical Management of Gastrointestinal Hemorrhage." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534130/all/Medical_Management_of_Gastrointestinal_Hemorrhage.
Medical Management of Gastrointestinal Hemorrhage. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534130/all/Medical_Management_of_Gastrointestinal_Hemorrhage. Accessed October 10, 2024.
Medical Management of Gastrointestinal Hemorrhage. (2010). In Pocket ICU Management. PocketMedicine.com, Inc. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534130/all/Medical_Management_of_Gastrointestinal_Hemorrhage
Medical Management of Gastrointestinal Hemorrhage [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2024 October 10]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534130/all/Medical_Management_of_Gastrointestinal_Hemorrhage.
* Article titles in AMA citation format should be in sentence-case
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