In a patient with suspected upper gastrointestinal bleeding, the first steps are airway and access, fluid or blood to restore perfusion, correction of coagulopathy where relevant, and early acid suppression as your protocol directs. A risk score such as Glasgow-Blatchford helps decide who needs admission and how quickly endoscopy is needed.
Endoscopy is more effective and safer in a stabilised patient, so use the time to resuscitate, assess risk and prepare.
- Secure access, restore perfusion and check haemoglobin and clotting early.
- Use a risk score to decide admission and urgency.
- Review anticoagulants and antiplatelets and decide what to hold.
- Arrange endoscopy once the patient is stable, within the timeframe in your guideline.
Why it matters
A fast scope in an unstable patient is not a substitute for resuscitation.
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