A 54-year-old man presents with large-volume haematemesis and melena. He is pale and sweaty. Observations: BP 88/55 mmHg, HR 120 bpm, RR 26/min, SpO2 ...

Question

A 54-year-old man presents with large-volume haematemesis and melena. He is pale and sweaty. Observations: BP 88/55 mmHg, HR 120 bpm, RR 26/min, SpO2 94% on 15 L/min oxygen. What is the most appropriate immediate management?

Accepted Answer

Give a rapid infusion of 1–2 litres of crystalloid while arranging urgent endoscopy

Answer

Arrange urgent CT angiography of the abdomen

Answer

Start oral Omeprazole and arrange outpatient endoscopy

Answer

Give Propranolol to reduce portal pressure

Answer

Discharge with advice to avoid NSAIDs

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

A 54-year-old man presents with large-volume haematemesis and melena. He is pale and sweaty. Observations: BP 88/55 mmHg, HR 120 bpm, RR 26/min, SpO2 94% on 15 L/min oxygen. What is the most appropriate immediate management?