A 56-year-old man presents with haematemesis and melaena. He is pale and clammy. Observations: BP 86/54 mmHg, pulse 120 bpm, respiratory rate 24/min, ...

Question

A 56-year-old man presents with haematemesis and melaena. He is pale and clammy. Observations: BP 86/54 mmHg, pulse 120 bpm, respiratory rate 24/min, oxygen saturation 95% on air. What is the most important immediate management step?

Accepted Answer

Insert two large-bore intravenous cannulae and start fluid resuscitation with 0.9% sodium chloride.

Answer

Arrange urgent upper GI endoscopy within 24 hours.

Answer

Give intravenous Omeprazole bolus followed by infusion.

Answer

Start an infusion of intravenous Metoclopramide.

Answer

Insert a nasogastric tube to assess ongoing bleeding before further interventions.

uk-plab-1 MCQ (SBA): Upper gastrointestinal bleeding

A 56-year-old man presents with haematemesis and melaena. He is pale and clammy. Observations: BP 86/54 mmHg, pulse 120 bpm, respiratory rate 24/min, oxygen saturation 95% on air. What is the most important immediate management step?