G.I. Bleed Flashcards

0
Q

Basic steps in a patient vomiting blood?

A
#IV access/type and cross
#Don't necessary need NG tube to confirm G.I. bleed
#Endoscopy
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1
Q

Primary Sources of G.I. bleed? Percentages?

A

75% – upper G.I. tract
25% – colon/rectum
Few – jejunum/alien

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2
Q

Workup of red blood per rectum?

A
  1. IV access, type and cross
  2. NG tube to aspirate gastric contents
    #If upper source, endoscopy
    #If aspirate is white, duodenum still potential source, use endoscopy
    #If green, entire upper G.I. is excluded
  3. Anoscopy to rule out bleeding hemorrhoids
    #Angiogram with embolization if bleeding exceeds 2 mL/min
    #Tagged RBC study if bleeding between .5 and 2 mL/min
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3
Q

Patient presents with recent history of blood per rectum, but not actively bleeding – work up?

A
#Upper endoscopy if young
#Upper and lower endoscopy if old
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4
Q

Blood per rectum in a child – suspected diagnosis? Work?

A

Meckel’s diverticulum; technetium scan

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5
Q

Massive upper G.I. bleeding in patients with multiple trauma – suspected diagnosis? Confirm with? Best therapeutic options?

A

Stress ulcers; endoscopy;

Angiographic embolization and maintenance of gastric pH over 4

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