Diagnostic Testing for Patients with Gastrointestinal Hemorrhage
Ainsley Adams, Andrew C Meltzer
Initial evaluation for GI bleeding requires a complete blood count (CBC), complete metabolic panel (CMP), coagulation tests, a type and screen, and a serum lactate level. For suspected or possible upper GI bleed cases, an urgent endoscopy should be performed within the first 24 h of admission. For unstable lower GI bleed patients, interventional radiography and/ or surgery should be consulted in the ED. Additional interventions like tagged red blood cell scans may be part of the emergency department workup in some cases. Video capsule endoscopy has shown potential to risk stratify patients in the ED.