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Upper gastrointestinal haemorrhage — DIPIMC MCQ

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HardMedical EmergenciesUpper gastrointestinal haemorrhageDIPIMCDipIMC

A patient with known oesophageal varices has a large-volume haematemesis. The heart rate is 120, the blood pressure is 88/54, the peripheries are cool and the patient is becoming drowsy.

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Correct answer: B — Manage the airway, give oxygen, gain large-bore access, resuscitate and pre-alert for urgent transfer.

Massive upper gastrointestinal haemorrhage with shock requires airway protection, oxygen, large-bore intravenous access, haemodynamic resuscitation and rapid pre-alerted transfer for endoscopy or critical care. Oral antacids and elective referral are unsafe with active bleeding and shock. Definitive haemostasis is achieved in hospital, so transport is not delayed.

Reference: JRCALC Clinical Guidelines