Episode 101 GI Bleed Emergencies Part 1

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 10 October 2017

⏱️ 96 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this Part 1 of our two part podcast on GI bleed emergencies we answer questions such as: How do you distinguish between an upper vs lower GI bleed when it's not so obvious clinically? What alterations to airway management are necessary for the GI bleed patient? What do we need to know about the value of fecal occult blood in determining whether or not a patient has a GI bleed? Which patients require red cell transfusions? Massive transfusion? Why is it important to get a fibrinogen level in the sick GI bleed patient? What are the goals of resuscitation in a massive GI bleed? What's the evidence for using an NG tube for diagnosis and management of upper GI bleeds? In which patients should we give tranexamic acid and which patients should we avoid it in? How are the indications for massive transfusion in GI bleed different to the trauma patient? What are your options if the bleeding can't be stopped on endoscopy? and many more...

Transcript

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0:00.0	Few things get my heart rate up quite as fast as the concerned charge nurse who taps me on the shoulder and says...
0:07.0	Anton. EMS just brought a guy into recess bed two with a massive GI bleed who looks pre-arrest. We need you now.
0:16.5	There's no doubt about it. The GI bleed can be an ominous presentation.
0:27.9	That's because it fulfills the Holy Trinity of one, it can be deadly, two, it can be sneaky,
0:32.3	and three, we're not the only ones who definitively manage them.
0:36.6	The ED docs management of the GI bleed is vitally important.
0:45.9	Now on the show today, we've got the mighty return of two well-known EM educators who shared their best case ever stories with us on EM cases in the past.
0:49.0	Dr. Anon-Swamy Nathan, otherwise known as Swami.
0:58.4	You've probably seen or heard his name before on MRAP, Core EM.M. Key Notable Rebel E.M. All NYC.EM. The Teaching Institute. The list goes on and on. The incredible speaker and EM educator from New York City.
1:04.0	Welcome back to the show, Swami. It's great to be here, Anton. Really great to talk about this topic.
1:09.3	One of my favorite topics to discuss.
1:12.2	Great. And from San Antonio, Texas, the creator, founder, and editor-in-chief of the fantastic blog and podcast, Rebel EM, as well as the co-founder of the Teaching Institute, a dynamic speaker, amazing educator, double certified in EMN internal medicine,
1:29.2	the one, the only, the rebel himself.
1:32.4	Dr. Salim Rizé, it's great to have you back on the show, guys.
1:36.6	Thanks for having me, Anton.
1:37.8	I just, you know, for the record, Swami,
1:40.0	you kind of sound like the prostitute of foam
1:42.3	with all those projects you got going on.
1:44.5	No, no, prostitutes get paid.
1:50.9	All right.
1:51.8	Well, with that in mind, what are we going to learn on this episode, guys?
1:56.5	We figured that we were going to dive really deep into GI bleed, the upper, the lower,
	...

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