When a patient presents with hematemesis, the A, B, C’s of resus-citation should be instituted; two large bore IV’s are inserted and the patient given lactated Ringer’s in bolus form of approximately 1–2 li-ters if the patient has tachycardia or hypotension. An examination of the oral cavity and nasopharynx should be performed to rule out an oral or nasopharyngeal cause. A nasogastric tube should then be placed with an attempt to irrigate old or active new blood out of the stomach; there is no advantage between iced or room temperature saline lavage. The patient’s blood should be drawn and a type and crossmatching performed for six units of packed red blood cells. If the patient is unstable despite fluid resuscitation and administration of blood products, the patient should be taken directly to the operating room.
KeywordsDuodenal Ulcer Gastric Ulcer Esophageal Varix Bolus Form Duodenal Carcinoma
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