Massive GI Bleed!

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This episode of the ResusNation Podcast features Dr. Jenn Repanshek. When dealing with patients presenting with massive upper gastrointestinal (GI) bleeds, emergent management plays a crucial role in saving lives. Here are some summary points from the podcast. 

• Differentiating between patient perception and medical definition of massive upper GI bleeds is crucial.
• Rapid and effective resuscitation is vital, as these patients can deteriorate rapidly without warning.
• Initial steps include wearing personal protective equipment (PPE) and assessing the patient's airway, breathing, and circulation (ABCs).
• Volume resuscitation is a priority, using large-bore peripheral IV or central access if necessary.
• Nasal cannula for oxygenation, continuous monitoring, and early consideration of intubation are essential.
• Prompt activation of a massive transfusion protocol may be necessary for patients with massive upper GI bleeds.
• Clinical assessment guides transfusion requirements rather than relying solely on lab results.
• Intubation should be delayed until adequate resuscitation has taken place to prevent poor outcomes.
• Consideration of various treatment options (endoscopy, embolization, surgery) involves consulting with GI, IR, and surgical colleagues.
• Additional medications like PPI and octreotide may not have significant benefits during the initial resuscitation phase.