upper GI bleed Flashcards
causes
oesophageal varices
Mallory Weiss tear
ulcers
cancer
mallory weiss tear
tear of oesophageal mucos membrane
presentation
haematemesis
coffee ground vomit
meleana
haemodynamic instability
Glasgow-Blatchford Score
scoring system used in suspected upper GI bleed on initial presentation
establishes risk of having upper GI bleed to help make a plan
Glasgow-Blatchford Score - what features does it take into account
drop in Hb rise in urea BP heart rate melaena syncopy
why does urea rise in upper GI bleed
blood in GIT gets broken down by acid and digestive enzymes
one of breakdown products from this is urea
Rockall score
used for patients who’ve had endoscopy to calculate risk of rebleed and overall mortality
given as percentage
Rockall score - what does it take into account
age features of shock co-morbidities cause of bleeding endoscopic stigmata of recent haemorrhage e.g. clots
management
ABCDE Bloods Access: 2x large bore cannula Transfuse Endoscopy Drugs: stop anticoags+ NSAIDs
Mx - which bloods
Hb urea coag: INR, platelets LFTs crossmatch 2x units blood
what is group + save
lab checks patients blood group and keep sample of blood saved incase need to match blood to it
what is crossmatch
where lab find bloods and tests that it is compatible and keeps it in fridge ready to use if necessary
when to give platelets
active bleeding + thrombocytopenia
when to give prothrombin complex concentrate
patients taking warfarin that are actively bleeding
Mx - additional Mx id oesophageal varices suspected
terlipressin
prophylactic broad spectrum antibx
