Diagnostics
blood typing and cross matching
CBC
coagulation
Liver function studies
BUN, Creatinine, electrolytes, glucose
12 lead ECG
Critical actions
May do NGT
two large bore IVs
Blood transfusion if <7 grams/dL; <9 in older patients or with comorbities
correct coagulopathy elev INR and PC <50,000
Omeprazole: 80mg Iv bolus then 8mg/hr infusion
Octreotide 50mcg IV bolus then infusion of 20-50mcg/hr
Antibiotics: Ciprofloxacin 400mg IV or ceftriaxone 1g IV - for cirrhotics
Unstable: Eary endoscopy 6-24hrs
stable: 12-36hrs