Episode 126: Upper GI Bleeding Evidence and Controversies Part 2

This podcast addresses the diagnosis and management of upper gastrointestinal (GI) bleeding, emphasizing the importance of endoscopy and other interventions. Endoscopy is recommended within 24 hours for non-variceal bleeding and within 12 hours for variceal bleeding, but always after initial resuscitation. For persistent bleeding, transcatheter arterial embolization (TAE) is presented as a viable alternative to surgery, with the choice depending on institutional capabilities and patient-specific factors. The podcast also covers airway management, advising against routine intubation but outlining critical steps for intubation when necessary, such as pre-oxygenation, resuscitation, and the use of appropriate PPE. Risk stratification tools like the Glasgow-Blatchford score (GBS) are highlighted for assessing patient risk and guiding discharge decisions, though clinical judgment remains paramount.

Outlines

Part 1: Endoscopy, Timing, Guidelines

Part 2: Alternative Interventions, Variceal Management

Part 3: Intubation, Clinical Procedures

Part 4: Risk Stratification, Summary

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emDOCs.net Emergency Medicine (EM) Podcast

Part 1: Endoscopy, Timing, Guidelines

Endoscopy for Upper GI Bleeding: Diagnostic Tool and Hemostasis Method

Timing of Endoscopy: Balancing Resuscitation and Guidelines for Variceal vs. Non-Variceal Bleeding

Part 2: Alternative Interventions, Variceal Management

Beyond Endoscopy: TAE vs. Surgery and the Importance of Localization

Balloon Tamponade Devices: Short-Term Control for Variceal Bleeding

TIPS Procedure and Airway Management Challenges in Upper GI Bleeding

Part 3: Intubation, Clinical Procedures

Intubation Strategies: Resuscitation, PPE, and Suction Techniques

Part 4: Risk Stratification, Summary

Risk Stratification Tools: GBS, AIMS 65, and the Kanuka Score

Upper GI Bleeding: Summary of Key Management Strategies

Episode 126: Upper GI Bleeding Evidence and Controversies Part 2

emDOCs.net Emergency Medicine (EM) Podcast

Part 1: Endoscopy, Timing, Guidelines

00:04Endoscopy for Upper GI Bleeding: Diagnostic Tool and Hemostasis Method

Endoscopy for Upper GI Bleeding: Diagnostic Tool and Hemostasis Method

01:30Timing of Endoscopy: Balancing Resuscitation and Guidelines for Variceal vs. Non-Variceal Bleeding

Timing of Endoscopy: Balancing Resuscitation and Guidelines for Variceal vs. Non-Variceal Bleeding

Part 2: Alternative Interventions, Variceal Management

04:30Beyond Endoscopy: TAE vs. Surgery and the Importance of Localization

Beyond Endoscopy: TAE vs. Surgery and the Importance of Localization

06:08Balloon Tamponade Devices: Short-Term Control for Variceal Bleeding

Balloon Tamponade Devices: Short-Term Control for Variceal Bleeding

07:33TIPS Procedure and Airway Management Challenges in Upper GI Bleeding

TIPS Procedure and Airway Management Challenges in Upper GI Bleeding

Part 3: Intubation, Clinical Procedures

09:23Intubation Strategies: Resuscitation, PPE, and Suction Techniques

Intubation Strategies: Resuscitation, PPE, and Suction Techniques

Part 4: Risk Stratification, Summary

11:33Risk Stratification Tools: GBS, AIMS 65, and the Kanuka Score

Risk Stratification Tools: GBS, AIMS 65, and the Kanuka Score

15:21Upper GI Bleeding: Summary of Key Management Strategies

Upper GI Bleeding: Summary of Key Management Strategies