A 58-year-old man presents with large-volume haematemesis and melena. He is hypotensive at 84/50 mmHg with tachycardia 118 beats per minute. What is t...

Question

A 58-year-old man presents with large-volume haematemesis and melena. He is hypotensive at 84/50 mmHg with tachycardia 118 beats per minute. What is the most appropriate immediate management step in the emergency department?

Accepted Answer

Secure intravenous access with large-bore cannulae, start fluid resuscitation and crossmatch blood

Answer

Arrange urgent endoscopy without any further assessment

Answer

Give intravenous Proton pump inhibitor and discharge for outpatient endoscopy

Answer

Start oral Iron and arrange endoscopy in 2 weeks

Answer

Offer oral Tranexamic acid and observe

uk-plab-1 MCQ (SBA): Acute upper gastrointestinal bleed

A 58-year-old man presents with large-volume haematemesis and melena. He is hypotensive at 84/50 mmHg with tachycardia 118 beats per minute. What is the most appropriate immediate management step in the emergency department?