I recently attended an acute haematemesis who had a 2.5 hour transport time
to hospital (Scottish Highlands).
Standard prehospital treatment is iv fluids* and high flow oxygen. Would it
be useful to add an iv PPI or H2 blocker in cases such as this with a long
transport time? If so what agent would you recommend?
I know that recent large RCTs showed no benefit, but that this treatment is
still common in hospital.
The patient's bleeding settled spontaneously and he was discharged home well
(on a PPI) with a diagnosis of asprin induced peptic ulceration.
[* IV fluids to maintain hydration or to treat hypovolaemia. In the latter
case hypotensive resuscitation guidelines should be followed and BP
maintained at as close to 90mmHg as possible)
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
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