Endoscopy in Non-Variceal Upper GI Bleeding - Scoping Summary

Pre-Endoscopic Care:

 • Adequate resuscitation: Restrictive> Liberal strategy

 • ACG recs. GBS, high sens. >12 inc. risk for poor outcomes

 • Intubation: a/w adverse CP events - Reserve for airway protection/AMS/active hematemesis

 • Erythromycin 250mglV (5 to 30 mins prior); Prokinetics dec. repeat EGD, no benefit w/ Metoclopramide; Alternative IV Azithromycin - Azithromycin a/w better visualization than erythromycin

 • Pre endoscopic PPI: 80mg -> 8mg/hr dec. SRH and endotherapy; Infusion = 40mg IV BID

 • Know your endoscopic armamentarium

 • Start with EGD scope -> keep therapeutic scope as a back up

 • Maintain effective communication with ICU/primary team

Endoscopic Assessment and Therapy

Post Endoscopic Care



By Dr. Hassaan Zia @HassaanZiaMD via ScopingSundays @ScopingSundays



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