A 70-year-old man arrives with hematemesis and melena. Triage acuity is ESI 1; BP 78/44 mm Hg, HR 136/min, pale and diaphoretic. He takes warfarin

Question

A 70-year-old man arrives with hematemesis and melena. Triage acuity is ESI 1; BP 78/44 mm Hg, HR 136/min, pale and diaphoretic. He takes warfarin for a mechanical valve. Two large-bore IVs are being placed. Which of the following is the most appropriate initial action?

Accepted Answer

Begin blood product resuscitation and reverse anticoagulation while arranging urgent endoscopy

Answer

Wait for hemoglobin before resuscitating

Answer

Discharge after oral proton pump inhibitor

Answer

Give oral iron and outpatient follow-up

Answer

Perform barium swallow

GI bleed unstable — ABEM Board MCQ

A 70-year-old man arrives with hematemesis and melena. Triage acuity is ESI 1; BP 78/44 mm Hg, HR 136/min, pale and diaphoretic. He takes warfarin for a mechanical valve. Two large-bore IVs are being placed. Which of the following is the most appropriate initial action?