Upper GI Bleeding Flashcards
How does upper GI bleeding present?
Haematemesis
Coffee ground vomiting
Melaena
What are the common causes of upper GI bleeds?
Peptic ulcers Oesophagitis Gastritis Duodenitis Varices Malignancy Mallory Weis tears
What scoring systems areu used to risk stratify upper GI bleed patients in order to determine the timing of endoscopy?
Rockall score
Glasgow Blatchford score
AIMS65 score
Endoscopy is required in order to use which scoring system for upper GI bleeds?
Rockall score
What does the Rockall score for upper GI bleeds predict?
Mortality
What does the Glasgow Blatchford score for upper GI bleeds predict?
Mortality and the need. for intervention
How soon do moderate risk patients with GI bleed need an endoscopy?
Within 24 hours
How soon do low risk patients with GI bleed need an endoscopy?
Non-urgently, can be managed as outpatients
How soon do high risk patients with GI bleed need an endoscopy?
Emergency or within 24 hours
When should PPIs be used in the treatment of upper GI bleeds?
Post-endoscopy in high risk patients
What is the benefit of using PPIs post-endoscopy in the treatment of high risk upper GI bleeds?
Reduces risk of rebreeding
Reduces mortality
If a patient presenting with an upper GI bleed is on an NSAID, should this medication be continued?
No - NSAIDs should be stopped
If a patient presenting with an upper GI bleed is on aspirin, DOAC, warfarin or clopidogrel should these medications be continued?
Initially, these should be stopped but post-endoscopy these medications should be restarted
Why should aspirin, DOACs, warfarin and/or clopidogrel be restarted after endoscopic treatment for upper GI bleed?
Cardiovascular disease is the most likely cause of mortality in these patients
When should blood transfusions be given to patients with an upper GI bleed?
When Hb <7-8g/dL
