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Related Experiment Videos

Hemodynamically stable upper gastrointestinal bleeding.

K D Wrenn1, L B Thompson

  • 1Department of Medicine, Grady Memorial Hospital, Atlanta, GA.

The American Journal of Emergency Medicine
|July 1, 1991
PubMed
Summary
This summary is machine-generated.

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Patients with hematemesis (vomiting blood) can often be safely discharged from the emergency department (ED) after a 6-hour observation period if they meet specific criteria, avoiding unnecessary hospital admissions.

Area of Science:

  • Emergency Medicine
  • Gastroenterology
  • Clinical Outcomes

Background:

  • Hematemesis is a common emergency department presentation.
  • Determining appropriate disposition for stable hematemesis patients is crucial.

Purpose of the Study:

  • To evaluate the safety and efficacy of discharging hemodynamically stable hematemesis patients from the ED.

Main Methods:

  • Prospective evaluation of 38 patients presenting with hematemesis.
  • Observation period of 6 hours in the emergency department.
  • Assessment of vital signs, hemoglobin, comorbidities, age, and patient compliance.

Main Results:

  • 33 of 38 patients were discharged.
  • Only one patient required admission due to subsequent hemodynamic instability.

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  • No major morbidity or mortality observed in discharged patients during follow-up.

    • Conclusions:

    • Hemodynamically stable hematemesis patients meeting specific criteria can be safely discharged.
    • Discharge criteria include absence of orthostatic vital signs, significant comorbidities, age <60, hemoglobin >10 gm/dL, and patient reliability.
    • Short-term ED observation may reduce unnecessary hospitalizations for hematemesis.