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History; what does the patient mean, are they dizzy has it happened before, what happened then, PHX. Physical - what do they look like: siting up and chatting - pale and ,moribund. I would taylor my investigations to the patient. The well, mild epigastric pain that is actually describing haematemesis, I would do routine FBC (XMatch from the venflon) and - unusually for me - a CXR (excludes pneumomediastinum, you can be well at first then your ...well not!) Also good for the bronchogenic/oesophagenic "who would have thought it" nasties which crop up now and again. If every parmeter is normal home, GP follow up, endoscopy at his discression. If otherwise and still bleeding - the pale moribund ain't sayin much: I would Senstakin (only if cirrhosis etc could be a factor and anyway I hate them - bad experience as a student) or if active bleeder : fluid repolacement + RSI and hello theatre and the previously fast paged surgical guys to turn off the tap properly. But then that's just me. Iain (Canada nice this time of year?) __________________________________________________ Do You Yahoo!? Make a great connection at Yahoo! Personals. http://personals.yahoo.com