Acute Management

1. ABCs (primary survey) (resuscitation)

   • ETT - Endotracheal Intubation to protect airway from blood
   • IV Fluid Resuscitation for !Hypovolemia ↓
   • RBC transfusion if indicated

2. Pharmacotherapy

   • IV bolus or infusion of PPI (”-prazole”) → higher pH = better clot stability

3. Correct coagulopathy if applicable

4. Upper Endoscopy → within 24 h for sus. non-variceal cause

   • Confirm diagnosis
     • • Biopsy for H. pylori
   • Determine Prognosis
   • Treatment

   For PUD - Peptic Ulcer Disease :

   • Medical therapy: clean base, flat spot
   • Endoscopic therapy: adherent clot, visible vessel, spurting vessel

5. Escalation of treatment

   • Angiography (Intervention radiology)
   • Surgery

6. LT management

   • If need to take ASA (Asprin) → + PPI (”-prazole”)
   • If H. pylori positive → treat the infection