Basic algorithm for the management of<unk>  GI bleed. In most cases requiring emergency hospital admission, the bleeding will resolve spontaneously. If a patient is suspected of having severe blood loss they will most likely be placed on a vital sign monitor and administered oxygen either by nasal cannula or simple face mask. An intravenous catheter will be placed into an easily accessible area and IV fluids will be administered to replace lost blood volume. Endoscopic evaluation with a colonoscopy (and possibly an esophagogastroduodenoscopy to exclude an UGIB) should typically occur within 24 hours of hospital presentation. If the person with<unk>  is on low-dose aspirin for prevention of a first heart attack (i.e., the person has never had a heart attack before), stopping the aspirin is recommended. In contrast, if the person has previously had a heart attack, the aspirin should be continued despite the active<unk>  due to the benefits of preventing another heart attack and consequent death outweighing the risk of bleeding. Dual antiplatelet therapy (e.g., use of both aspirin and clopidogrel) should continue if the person with a<unk>  underwent stenting of the heart's coronary arteries within the last 30 days or a recent acute coronary syndrome episode (e.g., unstable angina or a myocardial infarction) within 90 days of the<unk>  event. Individuals at high risk of another heart attack but not meeting the above criteria should continue their aspirin during the<unk>  event but stop the other antiplatelet medication for 1–7 days following cessation of the bleed. Predicting which patients will suffer adverse outcomes, complications or severe bleeding can be difficult. One recent study identified poor kidney function (creatinine > 150 μm), age over 60 years, abnormal haemodynamic parameters on presentation (low blood pressure) and persistent bleeding within the first 24 hours as risk factors for worse outcome. Surgical intervention is warranted in cases of<unk>  that persist despite attempts to stop the bleeding with endoscopic or interventional radiology interventions. It is most likely that a surgical consult will be ordered if the patient is unable to be stabilized by non-invasive techniques, or a perforation is found that requires surgery (e.g., subtotal removal of the colon.
Lower gastrointestinal bleeding
Upper gastrointestinal bleeding
Internal bleeding
Rectal bleeding
Gastric varices
Gastrointestinal bleeding
Retroperitoneal bleeding
Nosebleed