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Obtain IV Access – get two large bore IVs (18g or larger)
Resuscitate – un-crossmatched blood at first, don’t forget type and screen!
Medicate – Give Pantoprazole always, Octreotide and Ceftriaxone if hx liver disease, reverse anticoagulation if indicated
Imaging – Upright CXR to assess for perforation, CTA if concerned for lower GIB
Consult – GI if unstable / if variceal bleeding
Disposition – based on amount of bleeding and hemodynamic stability