Sponsored by the Council of Residency Directors in Emergency Medicine
GI Bleeding
Resources to Review Prior to Conference
Goals and Objectives
Goals
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Trainee will demonstrate competence in the initial evaluation and management of patients with GI bleeding
Objectives
For patients with GI bleeding, trainee will be able to:
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List common etiologies of both upper and lower GI bleeding
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Define and recognize:
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Hematemesis
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Coffee-ground emesis
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Melena
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Hematochezia
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BRBPR
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List and discuss the indications, risks, and benefits of acute diagnostic interventions
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List and discuss the indications, risks, and benefits of medical interventions
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Blood products
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Anticoagulant reversal agents
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PPIs
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Somatostatin analogs
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Antibiotics
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Discuss the indications for admission, urgent vs emergent GI consultation, and surgical consultation
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Explain the concept of massive transfusion protocols and indications for use
Additional Resources
General Approach/Review
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Approach to GI Bleeding (CDEM 2019)
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GI Bleeding (IBCC 2018)
Upper GI Bleeding
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General
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Acute Upper GI Bleeding (BMJ 2019)
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Upper GI Bleeding in the ED (EB Medicine 2015)
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Clinical Decision Tools
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Glasgow-Blatchford Bleeding Score (MDCalc)​
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AIM65 Score (MDCalc)
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Lower GI Bleeding
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Acute Lower Gastrointestinal Bleeding (NEJM 2017)
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Acute Lower GI Bleeding: ACG Clinical Guideline (AM J Gastro 2016) (pdf)
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Reversal of Anticoagulation
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Management of Bleeding in Patients Taking Oral Anticoagulants (JAMA 2018)
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Decision Pathway: Bleeding in Patients on Oral Anticoagulants (ACC Expert Consensus 2017) (pdf)
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Procedures
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Airway Management
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Intubating the Critical GI Bleeder (EMCrit 2009)
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Esophageal Balloon Devices
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Types of Esophageal Balloons (EM:RAP 2016)
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Blakemore Placement (EM:RAP 2016)
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Gastric Lavage
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NG Lavage: Indicated or Outdated? (ALIEM 2013)
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