Emergency MedicineGastroenterology
Upper GI Bleeding
Risk stratification and management of upper gastrointestinal haemorrhage using the Glasgow-Blatchford score and Rockall score.
Source: BSG Guidelines 2019; NICE NG141
Step 1 of ~8
action
Initial Resuscitation
Immediate management:
• IV access × 2 large-bore cannulae
• FBC, U&E, LFTs, coagulation, group and save (crossmatch 4–6 units if major haemorrhage)
• Fluid resuscitation: NaCl 0.9% to maintain systolic BP >100 mmHg
• Target Hb ≥70–80 g/L with red cell transfusion (80 g/L if ACS or haemodynamic compromise)
• Correct coagulopathy: FFP if PT >1.5× normal; platelets if <50 × 10⁹/L
• Do NOT use fibrinogen/TXA routinely in UGI bleed
• Nil by mouth pending endoscopy
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Activated Charcoal · Gastrointestinal decontamination / Antidote
- Vasopressin / Terlipressin · Vasopressin Analogue — Vasodilatory Shock / Variceal Bleeding
- Terlipressin · Gastrointestinal Emergency
- Octreotide · Gastrointestinal Emergency
Pathways
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
- Syncope Assessment · ESC 2018 Syncope Guidelines; NICE NG109
- Acute Chest Pain · NICE CG95; ESC 2023 ACS Guidelines
Decision support only. Always apply local guidelines and clinical judgement.