Even More Bleeding

Gastrointestinal System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This young lady has presented with acute upper gastrointestinal (GI) bleeding, as evidenced by the coffee ground vomiting and melena.\n\nExamination reveals the presence of hypotension and tachycardia, i.e. she is in stage III hypovolemic shock. This is a medical emergency - immediate resuscitation and stabilization is essential and should supercede further diagnostic evaluation.\n\nThe first goal of resuscitation should be to replace the lost intravascular volume; large bore cannulae should be inserted and IV crystalloids should be commenced immediately, while blood should be cross matched and transfused as soon as is feasible.\n\nNote that her full blood count (FBC) should not be use to guide the management, as hemoglobin (Hb) levels do not re"}]}

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