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
1
Q
Primary Sources of G.I. bleed? Percentages?
A
75% – upper G.I. tract
25% – colon/rectum
Few – jejunum/alien
2
Q
Workup of red blood per rectum?
A
- IV access, type and cross
- 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 - 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
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
4
Q
Blood per rectum in a child – suspected diagnosis? Work?
A
Meckel’s diverticulum; technetium scan
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