Esophageal Variceal Bleeding - Scoping Summary GENERAL PRINCIPLES OF MANAGEMENT (VARICEAL-B): V - Vasoconstrictor therapy: (Octreotide 50mcg bolus -> infusion for 2-5 days) A - Antibiotics : ( Ceftriaxone Igm IV Qdaily for 5-7 days) -> consider stopping once hemostasis is acquired/vasoactive meds dc'd, do not extent as an OP R - Resuscitation/Restrictive (Critical, Target Hgb>7gm/dL) I - ICU level care/ Intubate -> Individualize ; intubation a/w adverse CP outcomes Hayat et. al GIE 2017, consider for active hematemesis, AMS C - Coagulopathy -> Don't reverse INR, PLTs>50, Fibrinogen >120 refer to AGA practice guidelines; TEG -> dec. in blood products E - Endoscopy - W/in 12 hrs of presentation AL - ALternative/Rescue Tx B - Beta blockade -> Do not initiate in acute settings - Pre-endoscopic Care - Endoscopy 101 - Post-Banding Ulcers - Refractory Bleeding and Rescue Therapies - Controversies Regarding Variceal Bleed Management By Dr. Hassaan Zia @HassaanZiaMD via ScopingSundays @ScopingSundays #Esophageal #Variceal #Varices #Bleeding #Summary #Endoscopy #diagnosis #management #algorithm #VARICEALB #Mnemonic
