Upper GI Bleeding
Impression: UGI Bleeding
Condition: Fair – Poor
Diet: NPO
Activity: Bed rest
Vital Sign: Q1h till stable
• Consider orthostatic hypotension
Please:
1. CBC, BUN, Cr, Na, K, UA
2. PT, PTT, INR
3. VBG ( assess Metabolic acidosis)
4. Stool OB
5. NG tube / Irrigation ( till clear )
6. Check Hb q6h
7. Correct coagulation profile ( if needed )
8. Pantoprazole 80 mg IV stat, then 8 mg/hr.
9. IV fluid : NS if hypotension ( stabilize hemodynamic )
10. Prepare 1-2 bag PC
11. Transfuse PC:
• IF Hb<8 mg/dl
• IF Hb<10 mg/dl plus comorbidity such as CHF
12. GI Internist consult ( for Endoscopy )
• Emergency endoscopy if active bleeding
