Exam (elaborations)
ISBAR GI bleed Final
- Course
- Institution
- Book
ISBAR GI bleed Final
[Show more]
Connected book
Book Title:
Author(s):
- Edition:
- ISBN:
- Edition:
Seller
Follow
morrismuriithi009
Content preview
ISBAR GI bleed Final,Patientmost common emergency of the GI tract - ANSWER: GI bleeding
mortalilty risk for GI bleed - ANSWER: 10%
factors that affect mortality - ANSWER: cardio-pulmonary disease
cancer
liver disease
ACUTE GI BLEEDING - ABC's of management - ANSWER: A-Airway
B-Breathing : Assess need to be intubated
C-Circulation- Assess hemodynamic stability
*NGT Lavage:* assess for an upper GI bleed
*Labs:* CBC, Electrolytes, Liver Function Tests, PT & PTT, Type & Cross
*History: * Assess risk factors for the different types of GI bleeding
4 main categories of G.I. bleeding - ANSWER: 1. Upper G.I. tract → esophagus,
stomach, proximal small bowel
2. lower G.I. tract → colon
3. occult G.I. bleed → patient unaware they are bleeding, but may see evidence with
an iron deficiency, anemia or guaiac + stools
4. obscure G.I. bleed → bleeding is obvious to the patient and the clinician, but
unable to identify the source
Ratio of upper G.I. bleeding to lower G.I. bleeding - ANSWER: 5:1
4 fundamental clinical principles that apply to G.I. bleeds - ANSWER: 1. Immediate
assessment and stabilization of the patient's hemodynamic status
2. careful history and physical exam
3. prediction of the etiology/source of bleeding
4. specific investigation to delineate the source of bleeding and apply proper therapy
(upper endoscopy, colonoscopy, angiography)
Labs that should be ordered for suspected G.I. bleed - ANSWER: CBC
electrolytes
liver function tests
PT and PTT
crossing type for PRBC
Signs of G.I. bleeding - ANSWER: -Hematemesis
-melena
-hematochezia
-frequent stools-brown stool
, Hematemesis and/or melena - ANSWER: Usually upper G.I. bleed
-rarely melena can mean a bleed from the right:
Melena - ANSWER: Dark, tarry stools due to digested blood products in the G.I. tract
-slow source from the *right side of the colon*
Hematemesis - ANSWER: Vomiting blood
Hematochezia - ANSWER: Lower G.I. source
-rarely can be a brisk upper G.I. bleed
*bright red blood with or without stool, maroon-colored stool, or passage of blood
clots per rectum*
Interpretation of increased frequency stooling - ANSWER: More active bleed
Interpretation of vital signs - ANSWER: Normal → percent blood loss <10% → bleed
type = mild
orthostatic hypertension or tachycardia → percent blood loss between 10 and 20%
→ bleed type = moderate
shock → percent blood loss 20-25% → bleed type = massive
Hematocrit goals - ANSWER: -for elderly patients with known coronary artery disease
→ aim for >30
-for younger patients who are otherwise healthy → aim for Hct 23-25
-take into account other comorbidities such as COPD/congestive heart failure
Reasons to give fresh frozen plasma - ANSWER: -To normalize the INR
-patient on ASA and Plavix
Patient history of chronic NSAID use - ANSWER: risk for gastritis, gastric ulcers,
duodenal ulcers
Patient history of underlying liver disease - ANSWER: raises concern for variceal
bleeding and portal gastropathy
Patient history of diverticulosis - ANSWER: think diverticular bleed
History of abdominal aortic aneurysm repair - ANSWER: aortoenteric fistula
Patient history of unexplained weight loss - ANSWER: Malignancy
suspicion of chronic alcohol abuse - ANSWER: Suspect underlying liver disease so →
raises concern for variceal bleeding and portal gastropathy
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller morrismuriithi009. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
82215 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now