A man has a Glasgow-Blatchford score of 0 after a minor upper gastrointestinal bleed with normal haemoglobin, urea and observations. What is the appropriate disposition?
Answer and explanation
Correct answer: C. Consider outpatient management with early endoscopy arranged
- Step 1: A score of 0 identifies patients at very low risk who need no intervention.
- Step 2: NICE advises that people with a score of 0 can be considered for outpatient management.
Answer
Consider outpatient management with early endoscopy arranged.
Why not the others: Admit to intensive care for monitoring and transfusion: Intensive care is not needed for a low-risk bleed. Keep him nil by mouth for five days on a surgical ward: Prolonged fasting has no benefit. Immediate emergency surgery to control the bleeding point: Surgery is for failed endoscopic control.
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