Lower GI Bleed

# Lower GI Bleed
Patient presents with bright red blood per rectum concerning for lower GI bleed. History and rectal exam notable for ***. DDx includes anatomic (diverticulosis), vascular (angiodysplasia, hemorrhoids, ischemic, post-polypectomy), inflammatory (infectious, IBD, radiation) or neoplastic (polyp, carcinoma), as well as brisk upper GI bleed.
Dx
- CBC, CMP, INR, Type and screen
- Telemetry
- GI consult/Endoscopic evaluation per clinical scenario
Tx
- NPO
- 2 large bore IVs
- Transfuse to keep hgb >7
- If concern for brisk upper, Protonix 80mg bolus x1, followed by Protonix 40 mg IV BID
- Hold antiplatelet agent, anticoagulation, anti-hypertensives
- Correct coagulopathy (Goal plt > 50k, INR < 2.0)