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Upper GI Bleeding — ESEGH MCQ

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HardUpper GI and Ulcer BleedingUpper GI BleedingESEGH

A patient with massive ongoing haematemesis is agitated, hypoxic and has a Glasgow Coma Scale score of 7 despite initial resuscitation. What should precede urgent endoscopy?

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Correct answer: A — Early anaesthetic airway protection before urgent endoscopy

The best answer is “Early anaesthetic airway protection before urgent endoscopy”. Within 24 hours of admission The alternatives “Proceed directly to unsedated endoscopy”, “Give oral prokinetic therapy and observe”, “Delay endoscopy until spontaneous airway recovery”, “Use non-invasive ventilation during endoscopy” are plausible in related gastroenterology presentations but do not match the defining finding, threshold, sequence or UK pathway in this stem.

Reference: NICE CG141 acute upper gastrointestinal bleeding: https://www.nice.org.uk/guidance/cg141/chapter/Recommendations