A 60-year-old man presents to the emergency department with haematemesis and melena. He is pale and clammy. BP is 92/60 mmHg and HR 118 bpm. He takes ...

Question

A 60-year-old man presents to the emergency department with haematemesis and melena. He is pale and clammy. BP is 92/60 mmHg and HR 118 bpm. He takes low-dose aspirin and occasional ibuprofen. What is the most appropriate initial management step?

Accepted Answer

Resuscitate with intravenous crystalloids, establish large-bore IV access and arrange urgent endoscopy

Answer

Give oral PPI and discharge for outpatient endoscopy

Answer

Start warfarin to prevent portal vein thrombosis

Answer

Insert a nasogastric tube and delay resuscitation

Answer

Give intramuscular PPI and wait 24 hours before endoscopy

au-amc MCQ (SBA): Acute upper gastrointestinal bleeding

A 60-year-old man presents to the emergency department with haematemesis and melena. He is pale and clammy. BP is 92/60 mmHg and HR 118 bpm. He takes low-dose aspirin and occasional ibuprofen. What is the most appropriate initial management step?