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Management of gastrointestinal bleeding

Management of a patient gastrointestinal bleeding include
1.Admission of the patient
2.Reassure the patient
3.Establish an IV line
4.Assessment of blood loss by history and vital signs (HR, BP every hour)
5.Introduction of a nasogastric tube for assessment of the quantity and duration of bleed and can also be used for therapeutic cold water lavage in an attempt to arrest the bleed
6.Cross matching of blood to be done and haematocrit value to be determined
7.Indication for transfusion of blood
  • Acute or continuous blood loss
  • Patient in shock (HR > 120/min; systolic BP < 100 mm Hg; hourly urine output < 0.5 ml/kg/hr)
  • Hb < 10 gm% limited value in the management
  • PCV < 20% assessment of acute bleed
8.Therapeutic endoscopy: The technique is useful for control of bleeding (coagulating electrodes, heated probes and laser energy).Sengstaken-Blakemore's tube (for variceal bleed).