In this episode of "IM Basics," Dr. Amulya Anumolu provides a comprehensive overview of managing GI bleeds.

Patients often present with signs of volume loss like hypotension, tachycardia, pallor, altered mental status, or dizziness. Common complaints include vomiting blood (hematochezia) or dark, sticky, foul-smelling stools (melena). Melena specifically indicates an upper GI bleed because blood darkens as it passes through the GI tract. A disproportionately high BUN (e.g., 30:1 ratio) on CMP can also suggest an upper GI bleed. Bright red blood per rectum can be a lower GI bleed or as simple as hemorrhoids.

Initial Assessment & Stabilization:

• Ensure the patient has two large-bore IVs (16 or 18 gauge) in both forearms for rapid fluid and blood product administration. Central lines are too thin for ...