Resuscitation in oesophageal variceal bleeding
The primary aim of resuscitation is replacement of the circulating volume:
- venous access with a wide-bore cannula is essential
- central venous access permits measurement of venous pressure and the response to fluid infusions
- the following investigations should be performed urgently:
- full blood count
- clotting profile
- serum electrolytes
- volume replacement consists of:
- colloids (initially)
- blood
- fresh-frozen plasma, as a sourve of clotting factors
Excessive volume replacement should be avoided.
If the patient is comatose or is bleeding heavily then endotracheal intubation may be indicated to prevent aspiration.
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