Managing acute upper gastrointestinal bleeding in the acute assessment unit.
AAUs should develop and review protocols and local guidelines for the multidisciplinary team management of upper GI bleeding, for example with respect to: Early and appropriate resuscitation. Use of the tools for assessing severity. Timing of endoscopy, including recognising low-risk patients who could be discharged for outpatient investigation. Postendoscopy drug treatment, including appropriate and limited use of iv PPIs and Helicobacter pylori eradication therapy. Follow up, including referral for repeat endoscopy and/or urea breath testing. Regular review and audit of local guidance of the management of UGIB should become an integral part of an acute trust's clinical governance programme.
Department of Gastroenterology, Chelsea and Westminster Hospital, London. lotte.dinesen@chelwest.nhs.uk
Lotte
L
Dinesen
Martin
M
Benson
D004636:Emergency Service, Hospital; D004724:Endoscopy; D005762:Gastroenterology / Q000458:organization & administration*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006305:Health Status Indicators; D006490:Hemostatics / Q000627:therapeutic use; D006494:Heparin Antagonists / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D011379:Prognosis; D012151:Resuscitation; D012307:Risk Factors
D006490:Hemostatics; D006494:Heparin Antagonists