Recently I was asked to speak at the Texas College of Emergency Physicians (TCEP) conference April 2018. The particulars of this session were, five, 10 minute lectures on new indications for old drugs. My topic was the use of octreotide and somatostatin for undifferentiated upper gastrointestinal bleeding. This is a particular topic I have been getting more and more requests for, but didn’t really know the evidence behind why I was doing it. Does it help my patients or just another expensive medication, that takes up an IV with no clear patient oriented outcome? Read more →
Tag Archive for: GIB
Nasogastric lavage (NGL) seems to be a logical procedure in the evaluation of patients with suspected upper GI bleeding, but does the evidence support the logic? Most studies state that endoscopy should occur within 24 hours of presentation, but the optimal timing within the first 24 hours is unclear. Rebleeding is the greatest predictor of mortality, and these patients benefit from aggressive, early endoscopic hemostatic therapy and/or surgery. So what are the arguments for and against NGL?