Upper GI Bleed

Question 1

How should you treat upper GI bleed firstly?

Answer 1

RESUSCITATE then facilitate prompt endoscopy

Question 2

What score helps establish need for intervention?

Answer 2

The Blatchford Score

Question 3

What should be done after endoscopy?

Answer 3

Bolus 80mg iv PPI then 8mg/hr for 24 hrs (if not already started)
Usually iv only if endoscopic therapy given, otherwise high dose oral PPI
Start eradication therapy for H pylori if DU
Rpt Hb and monitor closely for signs of re-bleed

Question 4

Who should terlipressin be used for?

Answer 4

Consider in pts with known chronic liver disease, previous variceal bleed or stigmata of chronic liver disease on examination

Question 5

Which antibiotic is usually given to improve survival from variceal bleed?

Answer 5

septrin

Question 6

If bleed stops what should be given?

Answer 6

propanolol

banding programme

Question 7

If bleeding continues, what next?

Answer 7

EVL/S-P Tube/ TIPPs