A 60-year-old man presents with haematemesis and melaena. He is pale, clammy, tachycardic at 120 beats per minute and hypotensive at 80/50 mmHg. His c...

Question

A 60-year-old man presents with haematemesis and melaena. He is pale, clammy, tachycardic at 120 beats per minute and hypotensive at 80/50 mmHg. His capillary refill is 4 seconds. What is the most appropriate immediate management?

Accepted Answer

Resuscitate with large-bore intravenous access, crystalloid bolus and urgent crossmatch

Answer

Arrange urgent upper gastrointestinal endoscopy without resuscitation

Answer

Give an immediate high-dose proton pump inhibitor infusion without fluids

Answer

Discharge with an urgent outpatient gastroenterology appointment

Answer

Start oral iron and review full blood count in 1 week

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

A 60-year-old man presents with haematemesis and melaena. He is pale, clammy, tachycardic at 120 beats per minute and hypotensive at 80/50 mmHg. His capillary refill is 4 seconds. What is the most appropriate immediate management?