Another GI bleeder scenario...

Posted
by tiezto tiezto Member

Specializes in Med/Surg/Telemetry.

I reviewed some previous posts on the topic, so please don't think I'm trying to beat a dead horse. I had a slightly different variation of the usual bleeder: 82/M with CC: knee pain, on tele for newly Dx'd a-fib. No known hx of liver prob's/GI bleeds. Dude has a blowout of 2L fairly bright red bloody stool out of the blue, shortly after that came about 400ml of coffee ground emesis. BP starts trickling down about 20 minutes later - by this time, our RRT RN & covering attending have been present.

My question is this: Given the frank blood visible in the lower GI, and old blood in the stomach, was it appropriate to attempt to place a soft NGT? I saw the MD's point with a cool NS lavage, but unless you know where the bloods coming from, is it worth risking popping possibly bulging varices? The reason I ask is due to 2 peers reacting in horror when I agreed to assist insert the tube. Obviously this guy needed to be scoped & quick - he was transferred to the ICU in less than 40 minutes from the first bloody surprise.

Please advise as to which types of GI bleed you should not drop a nose hose - :confused:

Much mahalo's!