Do you know?
- Melena suggests a proximal GI bleeding source in which there is time for enzymatic breakdown to transform blood to melena. How much blood in the stomach does it take to cause melena?
- What is a Morel-Lavallee lesion
- What is an Essex–Lopresti injury?
- What is the number one cause of fatal ingestions in children under 5 years of age (in the US)?
- What topical medication has been recently reported as a cause of methemoglobinemia in infants and children?
Management of a massive GI bleed
For known upper GI bleed, give PPI as soon as access is obtained – it makes endoscopy easier. Decreasing the acidity provides benefit acutely by improving platelet function, and in the long run by adding mucosal protection. Start with an 80 mg bolus followed by 8 mg/hr of Esomeprazole or Pantoprazole.