Acute upper gastrointestinal bleed: resuscitation, risk assessment and endoscopy

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Educational simulation. Not for real patient care and not a substitute for supervised training. Always follow local protocols.

What you will practise

Prioritise airway, breathing and circulation and start resuscitation before investigating the cause of an upper GI bleed.
Recognise signs of hypovolaemic shock and choose a restrictive, protocol-driven approach to fluid and blood products.
Apply a validated risk score to separate high-risk patients from those who may be suitable for outpatient care.
Explain why chronic liver disease changes the initial management of a suspected variceal source.
Describe the role and timing of upper GI endoscopy per local protocol and the follow-up steps after endoscopic therapy.
Identify medicines that contribute to bleeding and plan their review and gastroprotection.

In portal hypertension, oesophageal varices develop at the anastomosis between which veins?
Where in the gastrointestinal tract is most dietary iron absorbed?
Why does a low dose of aspirin have a prolonged antiplatelet effect lasting about the lifespan of platelets?
A man with acute gastrointestinal bleeding has a pulse of 124/min, blood pressure 85/55 mmHg and cool peripheries. Which initial intravenous fluid is most appropriate while blood is being arranged?