假如找不到或看不清楚 bleeders，若病人 clinical conditions 允許，可以請病患右側躺 –> more likely to expose vessels
Suspect high body bleeding.
19:04 1st PES
Golden standard : performance within 24hrs
病患 BP dropped , pulse rate 120-140bpm —> class III
By Ian Chen: 錯字修正 tract (但應該不用加 tract, 用 upper gastroinstenstinal bleeding 即可)；本文所有 track 均修正為 tract。
No second look ?
Shock 之後才做
應早期 second look
Airway protection
若找到 bleeder
可用 endoscopic hemostasis
可用 angiography :embolization
可用 erythromycin 可增加 gastric visuality
Erythromycin (a dose of 250 mg iv 30 minutes before endoscopy) increases gastric motility and improves visualization of the gastric mucosa at endoscopy.
A meta-analysis of 4 RCTs showed that the use of erythromycin decreased the need for blood transfusion and repeat endoscopy.
Aliment Pharmacol Ther 2011; 34: 166-71
Celiac (DSA)
Celiac (No DSA)
Left gastric artery
Splenic artery and Short gastric artery
Repeated celiac a.