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GI Bleeding


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GI Bleeding

  1. 1. Nursing faculty Gastrointestinal Bleeding instructor : Mohammad Abu Awwad Presented by: Ashraf ISSA 14/11/2009 Hebron university
  2. 2. Out line <ul><li>Introduction </li></ul><ul><li>GI Bleeding definition </li></ul><ul><li>Consideration </li></ul><ul><li>Causes of GI bleeding اسلوب التعامل </li></ul><ul><li>Signs for GI Bleeding </li></ul><ul><li>Upper GI Bleeds </li></ul><ul><li>Lower GI Bleeds </li></ul><ul><li>Management / Treatment </li></ul><ul><li>Tests for GI bleeding pt </li></ul>
  3. 3. Introduction <ul><li>My goal in this study is to clarify the GI Bleeding and how we should deal with it while they exist . </li></ul><ul><li>And the subject does not display the details are only the main information of interest to us as students, trainees </li></ul>
  4. 4. Statistics <ul><li>In 2006, hospitalizations for upper GI bleeding covered a wide age range—47 percent of admissions for patients </li></ul><ul><li>65 to 84; 25 % for patients 45 to 64; 18 % for patients older than 85; and 10 percent for patients under 45. </li></ul><ul><li>The number of hospital patients who died from </li></ul><ul><li>upper GI bleeding fell from 20,013 in 1998 to 16,344 in 2006 </li></ul><ul><li>A new study suggests that aspirin therapy on long - term doses greater than 75 to 81 mg per day does not enhance the prevention of heart disease but does increase the risk of stomach bleeding, contrary to what many doctors . </li></ul>
  5. 5. GI Bleeding Gastrointestinal (GI) bleeding refers to any bleeding that starts in the gastrointestinal tract, which extends from the mouth to the anus. The amount of bleeding can range from nearly undetectable to acute, massive, and life threatening.
  6. 6. Consideration <ul><li>GI bleeding can range from microscopic bleeding ( the amount of blood is so small that it can only be detected by laboratory testing ) to massive bleeding (pure blood is passed). </li></ul><ul><li>It is important to be aware of GI bleeding, because it may point to many significant diseases and conditions. Prolonged microscopic bleeding can lead to loss of iron, causing anemia. </li></ul><ul><li>. Acute, massive bleeding can lead to hypovolemia , shock and even death. </li></ul><ul><li>GI bleeding can occur at any age from birth on. The degree and suspected location of the bleeding determines what tests should be performed to find the cause. </li></ul>
  7. 7. Causes of GI Bleeding <ul><li>Arterio - venous malformations ( تشوهات </li></ul><ul><li>Cancer of the small intestine </li></ul><ul><li>Anal fissure </li></ul><ul><li>Cancer of the small intestine </li></ul><ul><li>Colon cancer </li></ul><ul><li>Gastric (stomach) ulcer </li></ul><ul><li>Stomach cancer </li></ul>
  8. 8. Signs for GI Bleeding <ul><li>Hematemesis : vomiting of bright red blood, indicating rapid upper GI bleeding </li></ul><ul><li>Dark blood mixed with the stool </li></ul><ul><li>Melena – dark stool </li></ul><ul><li>Bright red blood coating the stool </li></ul><ul><li>Coffee-grounds appearance of vomit </li></ul>
  9. 9. Physical Exam for GI bleeding patient Including: <ul><li>HR, BP, tilt test, RR, O 2 saturation </li></ul><ul><li>General appearance, Mental status </li></ul><ul><li>Neck veins, oral mucosa </li></ul><ul><li>Skin temperature and color </li></ul><ul><li>Abdominal exam </li></ul><ul><li>Urine output </li></ul>
  10. 10. Upper GI Bleed Upper GI bleeding: The upper GI tract is located between the mouth and the upper part of the small intestine. Hematemesis refers to vomiting of clots, fresh blood, or “coffee grounds” and generally represents bleeding from the upper GI tract 50% present with hematemesis NGT with positive blood on aspirate Melena (black tarry stools)
  11. 11. Lower GI Bleed <ul><li>Lower GI bleeding: The lower GI tract is located between the upper part of the small intestine and the anus. The lower GI tract includes the small and large bowels. </li></ul><ul><li>Lower GI bleeds are most commonly detected by seeing blood in the stool. It will usually be bright red blood because it is a lower gastrointestinal bleed, and blood vomiting </li></ul>
  12. 12. Test that may be done <ul><li>Abdominal CT – scan </li></ul><ul><li>Abdominal MRI – scan </li></ul><ul><li>Abdominal X – Ray </li></ul><ul><li>Bleeding scan ( tagged red blood cell scan ) </li></ul><ul><li>Capsule endoscopy </li></ul><ul><li>Colonoscopy </li></ul><ul><li>LAP : CBC / BMP </li></ul>
  13. 13. Management and Treatment of GI Bleeding <ul><li>ICU admit </li></ul><ul><li>blood Transfusion </li></ul><ul><li>administration of IV fluids for maintenance of fluid and electrolyte balance, </li></ul><ul><li>Gastric Lavage (washing out the stomach with sterile water or a saltwater solution; removes blood or poisons;. Tube through the mouth into the stomach to drain the stomach contents </li></ul><ul><li>Surgery may be necessary </li></ul><ul><li>upper GI and lower GI endoscopy to control bleeding. </li></ul><ul><li>Oxygen </li></ul><ul><li>Medication as </li></ul>
  14. 14. References <ul><li>Harrison’s Principles of Internal Medicine 14 th edition </li></ul><ul><li>Gastrointestinal endoscopy photos </li></ul><ul><li>Bjorkman D. GI hemorrhage and occult GI bleeding. In: Goldman L, Ausiello D. Cecil Textbook of Medicine . 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 137. </li></ul>