Upper gastrointestinal bleeding remains a common reason for emergency department visits and is a major cause of morbidity, mortality, and medical care costs. Often when these patients arrive, the classic IV-O2-Monitor is initiated and hemodynamic stability is assessed. Some of the next steps often performed include:
- Determination of the site and rate of bleeding (upper vs lower)
- Initiation of proton pump inhibitors (PPIs)
- Somatostatin analogs if variceal bleeding is suspected
- Prophylactic antibiotics
- Packed red blood cell (PRBC) transfusion for low hemoglobin and hematocrit levels
What is the evidence for these treatments, and do they affect morbidity and mortality?