Health Questions and Answers

Question: What is the initial approach to the patient who presents with acute GI bleeding?

Answer:

In any patient presenting with acute GI bleeding, the key word is resuscitation! The initial approach should include a rapid assessment to gauge the urgency of the situation, especially whether the patient is hemodynamically stable or unstable (blood pressure, pressure, and signs of orthostasis must be obtained). Venous access should be obtained with a large-bore IV cannula, and fluids such as normal saline should be begun immediately. Blood should be obtained for a complete blood count, clotting studies, platelets, routine chemistry, and type and cross-match.

Reference:  Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management, 7th ed. Philadelphia, W.B. Saunders, 2003.

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