Any medications or fluids will need to be prescribed at the time (in some cases you may be able to delegate this to another member of staff).Make use of your local guidelines and algorithms in managing specific scenarios (e.g.Review results as they become available (e.g.If you require senior input, call for help early using an appropriate SBARR handoverstructure.Clearly communicate how often would you like the patient’s observations relayed to you by other staff members.All critically unwell patients should have continuous monitoring equipment attached for accurate observations.Make use of the team around you by delegating tasks where appropriate.Re-assess regularly and after every intervention to monitor a patient’s response to treatment.Treat all problems as you discover them.General tips for applying an ABCDE approach in an emergency setting include: Haematochezia: the passage of fresh red blood per rectum, which can occur in the context of profuse upper gastrointestinal haemorrhage due to rapid transit of blood through the gastrointestinal tract.Malaena: black, tarry stools caused by the presence of digested blood.Typical clinical signs of upper gastrointestinal bleeding include: Pre-syncope/syncope: due to hypovolaemia and secondary cerebral hypoperfusion.Abdominal pain: typically epigastric in location, but can be diffuse.Altered bowel habit: patients may describe dark tarry stools or fresh rectal bleeding.Haematemesis: typically coffee-ground like in appearance due to the presence of partially digested blood.Typical symptoms of upper gastrointestinal bleeding include: You may also be interested in our overview of the ABCDE approach and other emergency management guides.Ĭlinical features of upper gastrointestinal bleeding Symptoms
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