EM Cases · Lower gastrointestinal bleed
Massive lower GI bleed — the unstable resus station
ACEM Fellowship OSCE resus station testing CTA-first pathway, restrictive transfusion, DOAC reversal, and rejection of UGIB drugs.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
An anticoagulated older man with massive haematochezia who is shocked on arrival.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
References2ShowHide
- [1]Sengupta N, et al. Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline American Journal of Gastroenterology, 2023.PMID 36735555
- [6]HALT-IT Trial Collaborators Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial Lancet, 2020.PMID 32563378