Table 3.
Clinicians deciding on the best next step in management of an actively bleeding patient with UGIB (see scenario below).
| A 50-year-old healthy patient presents with hematemesis and is hemodynamically unstable (BP 90/50, HR 115) with evidence of a volume deficit on clinical exam. Two large bore IVs were inserted and resuscitation was initiated with intravenous crystalloid. Routine blood work including a CBC and RBC cross-match has been sent. What would be your next steps? | |
|---|---|
| I would hold off on a blood transfusion until I know the hemoglobin level | 38.6% (31.8%; 46.0%) |
| I would wait for cross-matched RBCs and transfuse 1-2 units once available | 25.0% (19.2%; 31.9%) |
| It depends on how much the patient appears to be bleeding | 18.2% (13.2%; 24.5%) |
| I would transfuse 1-2 units of uncross-matched red blood cells STAT | 13.1% (8.9%; 18.6%) |
| It depends on patient's symptoms | 4.6% (2.3%; 8.7%) |
| I would wait for cross-matched RBCs and transfuse 3-4 units once available | 0.6% (0.1%; 3.2%) |