title: PROPOSAL OF A CLINICAL CARE PATHWAY FOR THE MANAGEMENT OF ACUTE UPPER GASTROINTESTINAL BLEEDING.
abstract: BACKGROUND
  Upper gastrointestinal bleeding implies significant clinical and economic repercussions. The correct establishment of the latest therapies for the upper gastrointestinal bleeding is associated with reduced in-hospital mortality. The use of clinical pathways for the upper gastrointestinal bleeding is associated with shorter hospital stay and lower hospital costs.
  
  
  OBJECTIVE
  The primary objective is the development of a clinical care pathway for the management of patients with upper gastrointestinal bleeding, to be used in tertiary hospital.
  
  
  METHODS
  It was conducted an extensive literature review on the management of upper gastrointestinal bleeding, contained in the primary and secondary information sources.
  
  
  RESULTS
  The result is a clinical care pathway for the upper gastrointestinal bleeding in patients with evidence of recent bleeding, diagnosed by melena or hematemesis in the last 12 hours, who are admitted in the emergency rooms and intensive care units of tertiary hospitals. In this compact and understandable pathway, it is well demonstrated the management since the admission, with definition of the inclusion and exclusion criteria, passing through the initial clinical treatment, posterior guidance for endoscopic therapy, and referral to rescue therapies in cases of persistent or rebleeding. It was also included the care that must be taken before hospital discharge for all patients who recover from an episode of bleeding.
  
  
  CONCLUSIONS
  The introduction of a clinical care pathway for patients with upper gastrointestinal bleeding may contribute to standardization of medical practices, decrease in waiting time for medications and services, length of hospital stay and costs.
authors: Hospital Universitário, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors: Matheus Cavalcante
authors: MC
authors: Franco
authors: Hospital Universitário, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors: Frank Shigueo
authors: FS
authors: Nakao
authors: Departamento de Endoscopia, Fleury Medicina e Saúde, São Paulo, SP, Brasil.
authors: Rodrigo
authors: R
authors: Rodrigues
authors: Departamento de Endoscopia, Instituto de Câncer de São Paulo, São Paulo, SP, Brasil.
authors: Fauze
authors: F
authors: Maluf-Filho
authors: Departamento de Endoscopia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors: Gustavo Andrade de
authors: GA
authors: Paulo
authors: Hospital Universitário, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors: Ermelindo Della
authors: ED
authors: Libera
mesh_terms: D000208:Acute Disease; D000328:Adult; D002985:Clinical Protocols / Q000592:standards*; D019468:Disease Management; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D017410:Practice Guidelines as Topic