Coda Change Gastrointestinal Haemorrhage
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Sep 13, 2020 Dive into the high-stakes world of upper gastrointestinal bleeding. Learn about the critical steps for managing a hypothermic patient with massive bleeding, including airway priorities and massive transfusion protocols. Discover the unique 'salad' suction technique and the importance of rapid intubation strategies. The podcast also explains the various balloon tamponade devices, their insertion, and best practices to avoid complications. Hear how a timely intervention stabilized a life-threatening situation, highlighting the importance of preparedness in emergency care.
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Hypothermia Case Turns Into Massive GI Bleed
- The speaker recounts a hypothermic woman who began vomiting massive amounts of bright red blood after arrival.
- The case sets up the challenge of bedside resuscitation for overwhelming GI bleeding and an immediately threatened airway.
Make Airway And Roles Your Immediate Priority
- Prioritize airway early when massive hematemesis causes aspiration risk and falling saturations.
- Prepare a double setup, assign roles, run massive transfusion, rewarm, and use multiple suctions before attempting laryngoscopy.
Use Paralysis, Suction And Bougie Tactile Technique
- Consider paralysis (ketamine + rocuronium) in controlled high-risk intubations to prevent coughing and aspiration.
- Use suction catheters deliberately (salad technique) and a bougie for tactile confirmation when vision is obscured by blood.