Gastrointestinal Bleeding — Expert Level Emergency Reference

Emergency · Clinical Specialties

How it begins

Expert-level clinical approach for diagnosis, hemodynamic resuscitation, endoscopic, pharmacological and endovascular therapy of upper and lower gastrointestinal bleeding in the emergency setting.

What it covers

1. Definitions, classification and epidemiology of gastrointestinal bleeding
2. · Epidemiology and Global Burden of Disease
3. · Emerging Risk Factors and Vulnerable Populations
4. Pathophysiology of hypovolemic shock and the systemic response
5. · Hemodynamic and Neurohumoral Compensation Mechanisms
6. · Pathophysiology at the Cellular Level, Ischemia and Lactic Acidosis
7. · The Triad of Death in Hemorrhagic Shock
8. Etiology of non-varicose upper gastrointestinal bleeding
9. · Peptic Ulcer Disease (PUD)
10. · Mucous Erosions and Stress Injuries
11. · Mallory-Weiss syndrome
12. · Dieulafoy injury
13. · Other Vascular and Neoplastic Causes
14. Etiology of varicose upper gastrointestinal bleeding
15. · Pathophysiology of Portal Hypertension and Varicose Vein Formation
16. · Varicose Rupture Factors
17. · Salin Classification for Gastric Varicose Veins
18. Etiology of lower gastrointestinal bleeding
19. · Diverticular Colon Disease
20. · Angiodysplasias (Vascular Ectasias)
21. · Ischemic Colitis
22. · Inflammatory Bowel Disease (IBD) and Anorectal Pathology
23. Initial evaluation, triage and hemodynamic stabilization in the emergency room
24. · Systematic Hemodynamic Evaluation
25. · Airway Securement (ABCDE of Resuscitation)
26. · Fluid Resuscitation and Hemodynamic Objectives
27. · Transfusion Strategy: Restrictive versus Liberal
28. · Correction of Coagulopathy
29. Risk stratification scales
30. · Glasgow-Blatchford Score (GBS)
31. · Rockall Scale
32. · AIMS65
33. · Oakland Score for Low Gastrointestinal Bleeding
34. Diagnostic and therapeutic approach to non-varicose upper gastrointestinal bleeding
35. · Acid Suppressive Pharmacological Therapy with PPI
36. · Appropriate Timing of Endoscopy (Timing)
37. · Use of Prokinetics: Erythromycin and Metoclopramide
38. · Endoscopic Hemostasis Techniques
39. · Refractory Management: Angioembolization and Surgical
40. Specific approach to varicose upper gastrointestinal bleeding
41. · Early Vasoactive Therapy
42. · Prophylactic Antibiotic Therapy
43. · Endoscopic Therapeutics: Band Ligation versus Tissue Adhesives
44. · Emergency Rescue Strategies
45. Diagnostic and therapeutic approach to lower gastrointestinal bleeding
46. · Emergency versus Elective Colonoscopy
47. · Stratification of Diagnostic Imaging Tests: CT Angio
48. · Superselective Rescue Angiography and Embolization
49. · Emergency Surgical Indications: Segmental Colectomy versus Subtotal
50. Gastrointestinal bleeding from the middle intestine (obscure origin)
51. · Definition and Change of Nomenclature
52. · Etiology of Midgut Bleeding
53. · Middle Intestine Diagnostic Testing Algorithm
54. Perioperative management of anticoagulated and antiplatelet patients
55. · Anticoagulation Reversal Protocols
56. · Management and Suspension of Antiplatelet Therapy
57. · Criteria for Safe Restart of Anticoagulation
58. Systemic complications, monitoring and intensive care
59. · Prerenal Acute Renal Failure (AKI) and Acute Tubular Necrosis (ATN)
60. · Myocardial Ischemia Type 2 (Secondary Myocardial Infarction)
61. · Hepatic Encephalopathy in Varicose Hemorrhage
62. Detailed emergency pharmacological protocols
63. Integrated decision-making algorithms and on-call checklist
64. · Decision Making Algorithm in Upper Gastrointestinal Bleeding (UGIB)
65. · Decision Making Algorithm in Lower Gastrointestinal Bleeding (LGIB)
66. · Safety and Quality of Care Checklist for the Emergency Department