If H/o epigastric ie. Ulcerlike pain. If H/o alcoholism & cirrhosis.
If Blood is coughed out & is mixed with sputum.
If blood is vomited out and is mixed with food particles.
If Blood is Bright red, frothy with sputum.
If blood is coffee ground But it may e fresh red if variceal bleeding
Litmus Paper = alkaline reaction
Litimus test = acid reaction
Step II: Start 18 No. I.V. Line
1. Start R-L or DNS, using 18 No. scalp vein needle (or 20 No.) and let the I.V run in very fast. 2. If lot of blood is lost, start Hemacele/Dextran. (Plasma expanders) 3. Make arrangements to shift the patient to a Hospital with Blood Transfusion facilities.
Step III: Measures to stop bleeding,
1. Inj. Calcium glucoante 10ml slow I.V. stat (Calcium =6G-3) 2. Inj. Dicyene 2ml I.V. stat & 4 hrly. (Ethamsylate = 6G-4) or Inj. Stryptochrome 2cc IM stat (Adrenochrome=6G-1) 3. Inj. Morphin 15mg IM stat (Narcotic analgesic = 3B-4 to 7) 4. Inj. Decadron 2cc I.V. stat (Dexamethasone = 9A-2,3 or 5)
If Hemetemesis,
1. Ryle’s tube and cold water stomach wash. 2. Inj. Ranitidine 1-2 amps I.V. (1B-2)
If Haemoptysis,
1. Inj. Cefazolin 500mg I.V. 6hrly. (Higher Antibiotic = 7A) 2. X-ray Chest and if hilar shadow, then Bronchoscopy.
