Upper GI Bleed Flashcards
What are the causes for an upper GI bleed? (4)
Oesophageal varices
Mallory-Weiss tear
Ulcers in stomach or duodenum
Cancers of stomach or duodenum
Presentation of Upper GI bleed? (4)
Haematemesis
Coffee ground vomit
Malaena
Haemodynamic instability (low BP, tachycardia, shock)
What score is used to assess risk of upper GI bleed in patients who have NOT had an endoscopy?
Glasgow-Blatchford score
What are the criteria for the Glasgow-Blatchford score? (6)
Hb drop
Urea rise
BP drop
Heart rate increase
Malaena
Syncope
What score is used to assess the risk of an upper GI bleed in patients who have had an endoscopy?
Rockall score
What factors are taken into account in the Rockall score? (5)
Age
Features of shock
Co-morbidities
Cause of bleeding
Endoscopic stigmata or recent haemorrhage
What is the management of an upper GI bleed? (6)
ABATED
A-ABCDE approach B-Bloods A-Access (2 large bore cannulas) T-Transfuse E-Endoscopy D-Drugs (STOP anticoagulants and NSAIDS)
What bloods should be done in an upper GI bleed? (5)
FBC U+E Coag LFT Crossmatch
What additional treatments can be given in an upper GI bleed if the patient has known varices? (2)
Terlipressin
Prophylactic broad spectrum antibiotics
What transfusion products should be given to patients with a massive haemorrhage? (3)
Blood
Platelets
FFP
What additional blood product should be given to people who have an upper GI bleed and are on warfarin?
Prothrombin complex concentrate
What is the definitive treatment for an upper GI bleed?
Oesophagogastroduedenoscopy (OGD)
