A 62-year-old man presents with large-volume haematemesis and melaena. He is pale and clammy. Observations: pulse 128 bpm, blood pressure 82/48 mmHg, ...

Question

A 62-year-old man presents with large-volume haematemesis and melaena. He is pale and clammy. Observations: pulse 128 bpm, blood pressure 82/48 mmHg, respiratory rate 26/min, oxygen saturation 94% on high-flow oxygen. What is the most appropriate immediate management step?

Accepted Answer

Insert two large-bore intravenous cannulae and start rapid infusion of crystalloid while arranging urgent blood and senior help

Answer

Prescribe oral Omeprazole 40 mg and arrange an endoscopy within 24 hours

Answer

Arrange an urgent CT angiogram to localise the bleeding site before resuscitation

Answer

Insert a nasogastric tube to confirm ongoing bleeding

Answer

Discharge on oral iron and arrange outpatient endoscopy

uk-plab-1 MCQ (SBA): Acute upper GI bleed

A 62-year-old man presents with large-volume haematemesis and melaena. He is pale and clammy. Observations: pulse 128 bpm, blood pressure 82/48 mmHg, respiratory rate 26/min, oxygen saturation 94% on high-flow oxygen. What is the most appropriate immediate management step?