Emergency Treatment Measures for Upper Gastrointestinal Bleeding

When dealing with upper gastrointestinal bleeding, the first step in emergency care is to restore blood volume. It is crucial to establish an effective intravenous (IV) line as soon as possible to administer large volumes of fluids and perform emergency blood transfusions if necessary. This helps stabilize the patient's condition and prevent complications caused by hypovolemic shock.

At the same time, the patient should remain in bed and be placed on complete fasting to reduce gastrointestinal activity. Vital signs must be closely monitored using electrocardiogram (ECG) equipment to detect any changes in heart function or overall stability. This level of care ensures prompt response to any deterioration in the patient's condition.

Pharmacological Intervention

Drug therapy plays a key role in controlling bleeding. A continuous intravenous infusion of somatostatin or octreotide is typically administered to reduce splanchnic blood flow and help control hemorrhage. Additionally, proton pump inhibitors (PPIs) such as omeprazole or lansoprazole are given intravenously to suppress gastric acid secretion, which promotes clot formation and prevents further irritation of the gastrointestinal lining.

Endoscopic Evaluation and Intervention

If active bleeding persists despite initial medical management, endoscopic evaluation should be performed urgently while continuing resuscitation efforts. An emergency gastroscopy allows for direct visualization of the bleeding site and helps identify the underlying cause, such as peptic ulcers, varices, or erosive gastritis. In many cases, endoscopic therapies like sclerotherapy, argon plasma coagulation, or mechanical hemostasis can be applied during the procedure to stop the bleeding effectively.

When Medical Treatment Fails

Surgical Intervention

In situations where bleeding cannot be controlled through medical or endoscopic means, immediate surgical intervention may be required. Surgery aims to locate and treat the source of bleeding directly, especially when endoscopic approaches are not feasible or have failed. Prompt surgical consultation should be considered early in the treatment process if the patient remains hemodynamically unstable despite aggressive resuscitation.