Upper GI Bleed

Blatchford / Rockall

First 30 seconds

  1. 1ABCDE, 2× large-bore IV
  2. 2Bloods + crossmatch 4 units
  3. 3Fluid resuscitation
  4. 4NBM, urinary catheter
  5. 5Pre-endoscopy: terlipressin + antibiotics if variceal

Bleeding from oesophagus, stomach, or duodenum.

A

Airway

  • Patent? Talking? Stridor?
  • Suction, jaw-thrust, adjuncts, definitive airway if needed
B

Breathing

  • RR, SpO₂, auscultate, percuss
  • O₂ to target sats, NIV / intubate as required
C

Circulation

  • HR, BP, cap refill, JVP
  • 2× large-bore IV, bloods, monitor, ECG
D

Disability

  • AVPU/GCS, pupils, glucose, temp
E

Exposure

  • Full exposure, skin, rash, bleeding, lines, infection source
View flowchart algorithm
WardRound

WardRound

Clinical Decisions in Seconds