The Resus Room17 Nov 2016

Upper GI Bleeding, what's the risk?

Patients frequently present to the Emergency Department either with direct concern following an upper gastro intestinal bleed, or with a history that points towards the diagnosis.

When these patients are haemodynamically unstable or with ongoing high volume bleeding the decision to admit or discharge becomes simple.

But when the episode has settled, deciding whether they are safe to be discharged and continue with outpatient follow up can be difficult. Lots of us use scoring systems such as the Glasgow-Batchford Score or the Rockall Score but how much do we actually understand regarding the 'positive' and 'negative' outcomes of those scores?

A recent paper on the topic helps to cast some light on the topic and forms the basis of this podcast.

One of the frequently used scoring systems is the Glasgow-Blatchford score below that bases it's score upon historical, physiological and laboratory findings.

mdcalc GBS scoring calculator

Probably the other most frequently used score in ED is the Rockall score, which in its full form utilises endoscopy findings, however for use in the ED (pre-endoscopy) it has been modified and utilised.

mdcalc pre-endoscopy Rockall Score

Have a listen to how these scores fare in the paper and it may inform your risk stratification in the ED.

Enjoy!

References and Further Reading

The Predictive Value of Pre-Endoscopic Risk Scores to Predict Adverse Outcomes in Emergency Department Patients with Upper Gastrointestinal Bleeding - A Systematic Review. Ramaekers R. Acad Emerg Med. 2016

Upper Gastro Intestinal Bleeding at St.Emlyn's

Denne episoden er hentet fra en åpen RSS-feed og er ikke publisert av Podme. Den kan derfor inneholde annonser.

Episoder(288)

Pupillary Reflex; Roadside to Resus

We assess the pupils in almost every significantly unwell or injured patient - but how much are they really telling us? It is easy to document 'pupils equal and reactive' and move on, yet a changing p...

15 Sep 55min

September 2026; papers of the month

Welcome back to September 2026's Papers of the Month, and this month we've got three papers that are really focused on the practical end of emergency and prehospital care. First up, we're looking at w...

1 Sep 36min

August 2026; papers of the month

This month we've got another really varied mix of papers that all have the potential to influence everyday emergency and prehospital practice. We start by asking a question that's becoming increasingl...

2 Aug 35min

Laryngectomy and Tracheostomy Emergencies; Roadside to Resus

Tracheostomy and laryngectomy emergencies are classic high-acuity, low-frequency situations. They do not happen every day, but when they do, airway problems can develop quickly, and the wrong interven...

16 Jul 50min

July 2026; papers of the month

Welcome back to July's Papers of the Month. This month we've got three papers that tackle some of the biggest questions we face in emergency and critical care medicine. They're all very different stud...

1 Jul 31min

Excellence in Facemask Ventilation; Roadside to Resus

Face mask ventilation is one of those skills that can easily be overlooked. It's often seen as the simple bit of airway management — something that sits below the glamour of videolaryngoscopy, fibre-o...

16 Jun 59min

June 2026; papers of the month

This month's episode takes us deep into trauma care, but not just the medicine we deliver but also the systems, circumstances and social factors that shape who survives and who doesn't. We start by lo...

1 Jun 32min

Reframing Anaphylaxis; Roadside to Resus

Anaphylaxis is one of those conditions we think we have got pretty well sorted. Recognise it early, give adrenaline, support the airway and circulation, and crack on. And in fairness, for the vast maj...

14 Mai 44min