Managing deteriorating Patients

Managing deteriorating patients with GI bleeding in recovery

Managing deteriorating patients with GI bleeding in recovery

Introduction

The purpose behind this paper is to show how to effectively manage deteriorating patients with upper gastrointestinal bleeding and to identify key strategies that can be implemented within healthcare organizations in order to ensure similar situations can effectively be avoided.

Upper gastrointestinal (GI) bleeding is a potentially life threatening situation that is a common cause of hospitalization. Upper gastrointestinal bleeding can be defined as bleeding from a source proximal with the Treitz ligament which basically connects the fourth portion of the duodenum to the diaphragms near the splenic flexure of the colon. The UGIB is one of the most common occurrences and a total of 100 cases per 100,000 populations per year are treated and diagnosed by it. Bleeding from the upper GI tract is a lot more common than the lower GI tract and is a major cause of mortality and approximately 6%-10% patients die due to UGIB. UGIB can be caused due to peptic ulcer erosion, erosive gastritis that may be caused due to the usage of Non-steroidal anti-inflammatory drug, oral corticosteroids or due to the intake of alcohol, mucosal diseases caused by stress which become apparent as gastric legions and oesophageal varices which usually lead to hepatic failure.

Mallory Weiss syndrome which is bleeding from a tear in the mucosa where the stomach and oesophagus join the major causes can be by retching and vomiting due to alcoholism. The treatment and diagnosis for non variceal upper gastrointestinal bleeding has drastically improved from passive oesophagogastroduodenoscopy until surgical interventions were included in the procedure with endoscopic procedures. Nonvariceal bleeding is caused due to arterial haemorrhaging which can be a result of ulcers and tears in the mucosa. The major cause of death occurs when in patients with upper gastrointestinal bleeding have a co morbid illness which is the presence of more than one disorder approximately 98.3% mortalities due to UGIB occur due to the presence of co morbid illnesses (NHS, 2012).

The most common cause behind UGIB is peptic ulcers. High risk patients of developing peptic ulcers are those who have a history of excessive drinking, renal failure and the usage of no steroidal anti-inflammatory drug. People with chronic live dysfunctions and hypertension are at a high risk of ulcer haemorrhage.

Gastric cancer, Dieulafoy lesions are also other causes of upper gastrointestinal bleeding, very rare occurrences have been seen where the cause of UGIB is an aortenteric fistula which occurs due to erosion within the aortic graft into the bowel lumen.

Discussion

In many situations the patients with acute GI bleeding start deteriorating instead of seeing any improvements the condition of the patient keeps worsening. It is necessary to make sure that patients are still being managed effectively in order to ensure that if the slightest bit of hope exists measures need to be taken to ensure the patient is receiving sufficient In case of early recognition of clinical deterioration in the condition of the patient needs ...