Bleeding Esophageal Varices Flashcards
what is esophageal varices?
Esophageal varices are abnormal, enlarged veins in the lower part of the esophagus — the tube that connects the throat and stomach–Esophageal varices occur most often in people with serious liver diseases. (like having an hemorrhoid in their esophagus)
what happens in esophageal varices?
when you have portal hypertension or high blood pressure in the liver, it forces collateral or new circulation to form. this circulation forms in 3 different places (stomach, esophagus, and rectum). this is why liver people tend to be GI bleeders. the high blood pressure is going to exert back pressure throughout the entire GI tract
*Beccause the portal vein going to the liver is blocked off, all of the blood that cannot get through it starts backing up to everywhere else, including the esophagus. and that’s where the bleeding comes in. if they unclog the portal vein, then the bleeding will most likely stop*
How do patients with esophageal varices usually present to the ER?
Vomiting large amounts of bright red blood
anytime someone is anemic, you give them___
oxygen
Why is sandostatin given to patients with esophageal varicies?
it lowers the blood pressure in the liver; since this is caused by liver hbp, if the pressure drops, then the bleeding should stop.
what is the purpose of the sengstaken blakemore tube?
told hold pressure on the bleeding varicy. (inserted like an NG tube, but it has balloons on it).
If a patient has been trying to pull out the sengstaken blakemore tube and the large balloon occludes their airway, what do you do?
cut it in 2 for immediate deflation and then pull the tube out. (keep scissors at the head of the bed)
why would a mag sulfate enema and a saline lavage be given?
to flush the blood out; or else it will increase ammonia levels.
why would neomycin be given?
will decrease ammonia producing bacteria
