GI BLEED — COMPLETE MEDICAL MANAGEMENT GUIDE

These flashcards cover the key concepts and management strategies outlined in the lecture notes on gastrointestinal bleeding.

Complete Medical Management Guide for GI Bleeds

A comprehensive protocol for managing gastrointestinal bleeding in ICU, ED, and interventional radiology settings.

Immediate Priorities in GI Bleeds

Airway protection, large-bore IV access, isotonic crystalloid fluids, blood transfusion if Hgb <7 g/dL, and coagulation management.

Upper GI Bleed - Variceal Treatment

Treat with octreotide, antibiotics (ceftriaxone), and PPIs, and perform endoscopy within 12 hours.

Upper GI Bleed - Non-Variceal Management

Use PPIs, perform endoscopy within 24 hours, and test/treat H. pylori.

Lower GI Bleed Stabilization

Initial stabilization, exclude an upper source, and perform colonoscopy within 24 hours.

Interventional Radiology (IR) Management for GI Bleed

CTA is indicated for brisk or ongoing bleeding to assess for embolization.

Erythromycin Before EGD

Optional adjunct treatment to enhance gastric emptying prior to endoscopy.

Massive Lower Gastrointestinal Bleeding (LGIB)

Requires CTA followed by interventional radiology embolization with a high success rate.

Spontaneous Bacterial Peritonitis (SBP) Diagnosis

Treat if polymorphonuclear leukocyte count (PMN) ≥ 250 cells/mm³.

Antibiotic Prophylaxis in SBP

Secondary prophylaxis may include norfloxacin, ciprofloxacin, or TMP-SMX.

Complete Medical Management Guide for GI Bleeds

A comprehensive protocol for managing gastrointestinal bleeding in ICU, ED, and interventional radiology settings.

Immediate Priorities in GI Bleeds

Airway protection, large-bore IV access, isotonic crystalloid fluids, blood transfusion if Hgb <7 g/dL, and coagulation management.

Upper GI Bleed - Variceal Treatment

Treat with octreotide, antibiotics (ceftriaxone), and PPIs, and perform endoscopy within 12 hours.

Upper GI Bleed - Non-Variceal Management

Use PPIs, perform endoscopy within 24 hours, and test/treat H. pylori.

Lower GI Bleed Stabilization

Initial stabilization, exclude an upper source, and perform colonoscopy within 24 hours.

Interventional Radiology (IR) Management for GI Bleed

CTA is indicated for brisk or ongoing bleeding to assess for embolization.

Erythromycin Before EGD

Optional adjunct treatment to enhance gastric emptying prior to endoscopy.

Massive Lower Gastrointestinal Bleeding (LGIB)

Requires CTA followed by interventional radiology embolization with a high success rate.

Spontaneous Bacterial Peritonitis (SBP) Diagnosis

Treat if polymorphonuclear leukocyte count (PMN) \geq 250 cells/mm^3.

Antibiotic Prophylaxis in SBP

Secondary prophylaxis may include norfloxacin, ciprofloxacin, or TMP-SMX.

Common methods for H. pylori detection?

Urea breath test, stool antigen test, and biopsy during endoscopy.

Mechanism of Octreotide in variceal bleeding

Reduces splanchnic blood flow and portal pressure, decreasing variceal bleeding.

Blood transfusion indications in GI bleed

Hemoglobin <7 g/dL, or <9 g/dL in patients with cardiovascular disease or active bleeding concerns.

Primary cause of variceal upper GI bleeds

Portal hypertension leading to esophageal or gastric varices.

Role of PPIs in non-variceal upper GI bleeds

Reduces gastric acid secretion, promoting clot stability and preventing re-bleeding.