drduck wrote:
patients life more important than ur diagnosis, as per the protcol stablise the patient and try control bleeding....then think of endoscopy.
thats the protocol all right.. but the thing is, here.. the patient has been stabilised n both octretide n endoscopy are therapeutic.
I wanna ask if we give octreotide empirically? on the basis of H/o cirrhosis.. without considering the cause fr the present bleed? coz fr all we know, he may have a bleeding NSAID ulcer.
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| chemamr
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yes, you give it empirically 
once you do the endoscopy, then you'll know the reason and then you can continue or discontinue this medication.
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| drduck
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| indidoc1
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thank u guys 
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| doyoudig
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A Pt w/ actve hematemesis and hypotension
as usuall ur initial step is
ABC
once stable (or let say Pt had an epsiode but no bleeding now) -- Nasogastic Tube to look for source of bleeeding, if coffe ground material is seen the EGD next -- it is dx n therapeutic (such as banding if esophageal varices are seen)
octreotride inidications are -- given either if CI to EGD exist, or EGD no available or before using EGD, good for smal bleeds bu EGD is superior
a Pt w/ Esophageal varices and Ascites -- EGD banding is done, BB are given as prophylaxis to prevent recurrent bleeds.
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