Question

A 52-year-old man with a history of chronic alcohol use presents with large-volume haematemesis and hypotension. Blood pressure is 85/60 mmHg, heart rate 120 beats/min. He is pale and clammy. Which is the most appropriate immediate management priority?

Accepted Answer

Immediate fluid resuscitation with intravenous crystalloids and blood products while arranging urgent endoscopy

Answer

Urgent upper GI endoscopy without resuscitation

Answer

Start high-dose intravenous proton pump inhibitor and discharge if bleeding stops

Answer

Insert a nasogastric tube and begin enteral feeding

Answer

Start oral propranolol immediately to reduce portal pressure

Practice question

A 52-year-old man with a history of chronic alcohol use presents with large-volume haematemesis and hypotension. Blood pressure is 85/60 mmHg, heart rate 120 beats/min. He is pale and clammy. Which is the most appropriate immediate management priority?