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    Lower GI Bleed

    GIB

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    Assessment & Plan (short)

    # 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)

    Organ systems
    • Gastrointestinal
    Medical field
    • Internal medicine
    Setting
    • Inpatient
    Author
    Eric Lee
    Page info

    Originally created: March 3, 2020 by Eric Lee

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    Number of revisions: [xyz-ips snippet="numrevisions"]

    References
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