NGN Case Study: GI Bleed Walkthrough
Upper GI bleed from presentation through endoscopy.
GI bleed case tests resuscitation, transfusion, source workup.
Presentation
70 y/o on warfarin for AFib. Hematemesis + melena × 24h. HR 118, BP 92/58. Hgb 7.2. INR 4.5.
Action
2 large-bore IVs, type & cross, transfuse PRBCs. Reverse warfarin (vitamin K + PCC). PPI drip. NPO. Urgent EGD.
Endoscopy
Likely ulcer or varices. Endoscopic intervention (cautery, clip, band ligation for varices).
Evaluate
Hgb stabilizing, HR down, BP up, no further hematemesis.
Frequently asked
Octreotide for variceal bleed?
Yes, reduces splanchnic blood flow. Plus antibiotics (prophylactic for SBP in cirrhosis).
Quick check
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