Essential Facts on the Go: Internal Medicine (15 page)

Isotonic fluid or blood

If upper GI bleed:

Nasogastric tube and lavage

Check CBC, PT, PTT, INR, type and screen

Liver disease: FFP

Kidney disease: DDAVP

On anticoagulation: Stop

GI consult

Ligament of Treitz

Above = upper GI bleed

Hematemesis

Melena

Coffee ground emesis

Bright red bold per rectum (very rapid bleed)

Below = lower GI bleed

Bright red blood per rectum

Hematochezia