Deep Dive MW R7

Obtain IV Access – get two large bore IVs (18g or larger)



Resuscitate – un-crossmatched blood at first, don’t forget type and screen!



Medicate – Give Pantoprazole always, Octreotide and Ceftriaxone if hx liver disease, reverse anticoagulation if indicated



Imaging – Upright CXR to assess for perforation, CTA if concerned for lower GIB



Consult – GI if unstable / if variceal bleeding



Disposition – based on amount of bleeding and hemodynamic stability