Team Welcome back.

Zach Labner here from med geeks.

Hope everyone enjoyed last week's podcast.

Over the next three weeks I want to dive into the GI bleeding patient.

I plan to break it up and look at upper GI. I bleed that is bleeding from above the ligament

atrites, the lower G. I bleed bleeding from below the ligament atrites and the scary liver

patient who has a G. I bleed. Plain and simple, G.I. bleed patients suck.

One minute they're sitting up in a structure conversing with stable

hemodynamics. You walk away, and a minute later the nurse calls you back because the patient had a large bloody valve movement and now they're confused with a systolic blood pressure in the 70s

So as we did last week we'll work through an upper GI bleed patient touching upon some

background evaluation and management during the case. So you get called about a

75-year-old male with complaints of three days of black stools.

The patient told the ED provider that he came to the ED because this morning he had a dark bowel movement and then develop some dizziness.

The patient 1. What are the patient's hemodynamics? Are we talking systolic blood pressure on the 1.30s with a normal heart rate?

Or does the patient of a systolic blood pressure in the high 80s, low 90s with a heart rate in the 110s 120s. In our case the patient's

blood pressure on arrival was 1.30 with a heart rate of 90 but over the past hour

the patient's blood pressures trended down to the mid 90s and the last couple checks

his heart rate has been in the 110s. The hemodynamics to me are a very important indicator of where the patient is heading.

Remember it's all about the trend.

The patient's down trending BP,

an increase in heart rate tell you that his body is responding

to some sort of volume loss.

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