Editing Upper GI bleed (section)

=== Initial management for admission ===

## ?ICU
## NBM
## TEDs, no enoxaparin
## IV PPI 80mg BD (leads to fewer Forrest Ia to Iia ulcers on endoscopy)
## Antibiotic prophylaxis in patients with cirrhosis
## May need NGT
## ?IDC
## Stop antihypertensives, anticoagulants and antiplatelets
## Consider correcting coagulopathies
## ?thiamine
## If suspected variceal bleeding (any symptoms or findings suggestive of portal hypertension)  - octreotide - not useful otherwise unless endoscopy unavailable - see below section on varices
## Probably no role for tranexamic acid (HALT-IT trial, 2020 - no benefit to mortality)
## AIMS65 score to predict in-hospital mortality from UGIB

### One point for each of:

#### Albumin <30
#### INR >1.5
#### Altered mental status
#### SBP <90
#### Age >65

### Each point is equally weighted and gives increasing mortality: 1, 5, 10, 15, 25%

## Glasgow-Blatchford score to identify low-risk UGI bleeds

###

## If big bleed, consider gastric lavage prior, or at least having a tube ready