Endoscopy in Non-Variceal Upper GI Bleeding - Scoping Summary Pre-Endoscopic Care: • Adequate resuscitation: Restrictive> Liberal strategy • ACG recs. GBS, high sens. >12 inc. risk for poor outcomes • Intubation: a/w adverse CP events - Reserve for airway protection/AMS/active hematemesis • Erythromycin 250mglV (5 to 30 mins prior); Prokinetics dec. repeat EGD, no benefit w/ Metoclopramide; Alternative IV Azithromycin - Azithromycin a/w better visualization than erythromycin • Pre endoscopic PPI: 80mg -> 8mg/hr dec. SRH and endotherapy; Infusion = 40mg IV BID • Know your endoscopic armamentarium • Start with EGD scope -> keep therapeutic scope as a back up • Maintain effective communication with ICU/primary team Endoscopic Assessment and Therapy Post Endoscopic Care By Dr. Hassaan Zia @HassaanZiaMD via ScopingSundays @ScopingSundays #NonVariceal #UpperGI #Bleeding #Summary #Endoscopy #diagnosis #management #algorithm
