November 14, 2016

Episode 72.0 – Upper GI Bleeding

14 minutes

This week we discuss upper GI bleeding pearls from a workshop we did in our weekly conference.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_72_0-UGIB_Final_Cut.m4a

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Tags: Aortoenteric Fistula, Gastric Ulcer, Gastrointestinal, GI, UGIB, Variceal Bleeding

Show Notes

Take Home Points

Respect the UGIB. These patients can bleed a lot. Even if they’re not actively hemorrhagic in front of you, realize that they can open up at any time and decompensate

Get your consultants on board early. A skilled endoscopist is your friend as they can get control of bleeding. Don’t forget IR for TIPS in variceal bleeds and general surgery in bleeding ulcers.

Activate your massive transfusion protocol if the patient is unstable and give the patient PRBCs, FFP and platelets as indicated. Reverse any anticoagulants as well.

Give all patients with confirmed or suspected variceal bleeding antibiotics – typically, ceftriaxone. This intervention saves lives and decreases morbidity.

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EMCrit: Episode 5: Upper GI Bleed Guidelines

EMCrit: Intubating the Critical GI Bleeder

The NNT: Prophylactic Antibiotics for Cirrhotics with Upper GI Bleed

The NNT: Somatostatin Analogues (Octreotide) for Acute Variceal Bleeding

EMRAP HD: Placement of a Blakemore Tube for Bleeding Varices

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