Sandbox: manpreet kaur

Management of Patients With Ulcer Bleeding

 Initial assessment and risk stratification :

Class I

"1.   1. Hemodynamic status should be assessed immediately upon presentation and resuscitative measures begun as needed (Strong recommendation).   (Level of Evidence: B-NR)"

Class IIa

1.Blood transfusions should target hemoglobin  ≥ 7   g / dl, with higher hemoglobins targeted in patients with clinical evidence of intravascular volume depletion or comorbidities, such as coronary artery disease (Conditional recommendation)    2. Risk assessment should be performed to stratify patients into higher and lower risk categories and may assist in initial decisions such as the timing of endoscopy, time of discharge, and level of care (Conditional recommendation).  3. Discharge from the emergency department without inpatient endoscopy may be considered in patients with urea nitrogen < 18.2   mg / dl; hemoglobin ≥  13.0   g / dl for men (12.0   g / dl for women), systolic blood pressure  ≥  110   mm   Hg; pulse   100 beats / min; and absence of melena, syncope, cardiac failure, and liver disease, as they have  <1 %  chance of requiring intervention (Conditional recommendation(Level of Evidence: B-NR)"