Core Content: GI Bleeds and Hemorrhagic Shock

The Pulmcast podcast episode discusses the critical topic of GI bleeds, differentiating between upper and lower GI bleeds, their common causes, and how they manifest in patients. The speakers emphasize the importance of early GI consultation for source control while simultaneously initiating resuscitation, including securing large-bore IV access and considering the use of rapid transfusion catheters. They delve into ICU admission criteria, hemoglobin targets for transfusion, and strategies for managing coagulopathy, including the use of PPIs, octreotide, vitamin K, and Kcentra. The episode also covers massive transfusion protocols, potential complications like hypocalcemia, and the importance of considering non-obvious sources of bleeding, such as retroperitoneal bleeds or hematologic conditions. The podcast concludes with a summary of key management steps, stressing the need to balance resuscitation with source control to improve patient outcomes.