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Abdominal Emergencies | GI Bleeding

Gastrointestinal (GI) Bleeding: rapidly result in hypovolemic shock.
Evaluate:

Is the airway open, obstruction due to vomiting blood is common
Is the patient in shock
Is active bleeding present

Upper GI is bleeding above the duodenum – top of small intestine
Lower GI is usually lesion in tract below the duodenum

Management:

  1. Maintain the airway
  2. Hi-flow O2
  3. Allow the patient to lie in a comfortable position
  4. Nothing by mouth
  5. Start in IV normal saline or LR
  6. Avoid pain meds that mask the symptoms
  7. Start IV line for normal saline or LR
  8. Monitor cardiac rhythm
  9. Prepare for vomit
  10. Consider AMI
  11. Transport gently but rapidly
  12. Be aware – more chance of shock

Terms

Hematochezia: bright red blood in stool
Melena: dark tarry stool – digested blood
Hematemesis: vomiting blood
Coffee-grounds vomitus: digestion of blood by stomach acids

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