Schiefer M. Eur J Gastroenterol Hepatol 2012;24(4):382-7.
Laursen SB. Clin Gastroenterol Hepatol
2012;10(10):1130-1135.
AIMS 65 predicts in-hospital mortality in UGIBAIMS65 score
superior in predicting inpatient mortality (1ry endpoint)Glasgow
Blatchford score superior in predicting blood transfusion (2ry
endpoint)Both scores similar in predicting rest of the 2ry
endpoints: composite clinical endpoint of inpatient mortality,
rebleeding, and endoscopic, radiologic, or surgical intervention;
ICU admission; rebleeding; length of stay; timing of
endoscopySaltzman JR. Gastrointest Endosc 2011;74(6):1215-24.Hyett
BH. Gastrointest Endosc 2013;77(4):551-7.
NG tube???Can rule out UGIB if concern is greater for LGIB (IF
bile present)Can clear the fundal poolCan reduce gastric distension
and need to vomit (which can worsen GI bleeding)NOT contraindicated
if concern for EVMost effective at providing risk stratificationNG
tube???Role of ice water lavage has been refuted7-11Unless being
used to clear fundal pool, should remove NG tube after
lavageRealize that compared to upper endoscopy, the NG tube
is:larger in diameterbeing passed blindlyless flexible7 Andrus et
al Am J Gastroenterol 82(10):1062-10648 Bryant et al Am J Surg
124(5):570-5729 Gilbert et al Dig Dis Sci 26(12):1065-106810 Moss
et al Am J Surg 122(4):565-56611 Rana et al J Assoc Physicians
India 38(5):377
