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Chapters
Transcript
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Initial Management of Upper GI Bleed
- Assess a patient's hemodynamic stability by checking vital signs, especially heart rate and blood pressure.
- Consider underlying conditions and medications like beta blockers that might mask tachycardia.
Resuscitation and Initial Steps
- Place two large-bore peripheral IVs for optimal fluid resuscitation, as they offer better flow rates than central lines.
- Administer an IV proton pump inhibitor (PPI) twice daily and keep the patient NPO.
Orthostatic Vitals
- Orthostatic vital signs can reveal blood loss between 15% and 40%, even before resting hypotension manifests.
- Consider the patient's overall health, age, and comorbidities when assessing risk.