Upper GI Bleeding Flashcards
Who usually gets Upper GI Bleeding?
- Alcoholics
- Those with Esophageal Cancer
What is usually the right course of action for someone going into shock?
Give fluids
What is gastric lavage?
Why do you perform gastric lavage?
Procedure in which you use an NG tube and put ice water into the GI tract and suck it back out and repeat
Decreases bleeding in GI Tract
How do you perform a Barium Contrast Study for a suspected upper gi bleed?
…Lower GI bleed?
Oral Barium Contrast or a Barium Enema
Describe an Arterial UGI Bleed…
Coffee-Ground Emesis
Melana
Arterial
- Profuse and Bright Red, indicating blood has not been in contact with acid secretions in stomach
Coffee-Ground Emesis- Blood has been in contact with stomach acids in a while
Melana- Black, Tarrry Stool, indicating Upper GI source
What causes UGI Bleeding in the Esophagus?
…Stomach and Duodenum?
Esophagus
- Chronic Esophagitis
- Esophageal Varices
- Bleeding from tear
Stomach and Duodenum
- Peptic Ulcers (penetrates into arteries)
What causes stress ulcers?
What causes gastritis?
(Both common causes of GI Bleed)
Stress Ulcers- burn, trauma, or major surgery
Gastritis- ingestion of DRUGS or ALCOHOL, reflux of bile from the small intestines
What are commonly associated with gastric carcinoma?
Hematemesis and Melena
What drugs can cause irritation and disruption of the gastric mucosal barrier?
- Aspirin
- NSAIDs
- Corticosteroids
What systemic diseases should also be considered for common causes of UGI Bleeds?
Blood Diseases
- Hemophilia
- Thrombocytopenia
- Leukemia
If you someone is in the ER for UGI Bleeding, what do you do FIRST?
What should it be focused on?
How should they focus on it?
Immediate Physical Examination (ASSESS) must include evaluation of the patient’s condition
Focuses on Hemorrhagic Shock and Hypovolemia
Check
BP
Rate and Character of Pulse
Peripheral Perfusion with Capillary Refill
If someone is in the ER for UGI Bleeding, what is the NEXT set of things you do?
Abdominal Examination- assess for bowel sounds
Get Complete history of events leading to bleeding episode
Blood work
Type and Cross-Match for possible blood transfusion
Vomitus, urine, and stool tested for occult blood and urine specific gravity (hydration)
What are some Emergency Management Interventions for someone with UGI Bleed?
- Fluid and Blood Replacement
O2 Delivered by face mask or nasal cannula for blood O2 saturation - Gastric Lavage to stop or slow bleeding (Give cold water, NG suction back out, repeat)
- Foley- Indirect measure of cardiac output
What are some diagnostic tests for UGI Bleeds?
Fiberoptic Panendoscopy (Gastroscopy or Endoscopy)
Angiography- If Fiberoptic Panendoscopy is unable to visualize
Barium Contrast Studies
What are some Collaborative techniques to stop the bleeding of an UGI bleed?
Thermal (heat) Probe
Electrocoagulation Probe
Laser
