Dr. Dan Fisher and Dr. Mitchell Weeman did an awesome job with their clinical pathway summarising ER management of both upper and lower GI bleeds. See brief lecture summary below and find their clinical pathway uploaded to the site for a more in-depth review.

1.  UGIB more common than LGIB; increased mortality with UGIB
2. GIB mimics: Pepto Bismol, Bismuth, Beets, red food colouring, bleeding from epistaxis/dental bleeding, red meat, iron supplements, vit C, horseradish, methylene blue
3. UGIB (proximal to ligament of Trietz; gastric>duodenal): most common aetioloy is PUD (NSAIDs, ETOH, ASA, Tobacco use), followed by erosive gastritis, oesophageal varices (high mortality) and Mallory Weiss tears; Risk stratification with Glasgow Blatchford Score
4. LGIB (distal to ligament of Treitz): most common aetiology haemorrhoids, diverticulosis/itis, aorto-enteric fistula (herald bleed), colitis, malignancy (ask about type B symptoms, Fhx), Meckels (in paediatric population)
5. ED workup: full history/physical, DRE, CBC, CMP (BUN:CR>36 w/o renal failure), type/screen, coags, guac stool test (if GIB can be pos for up to 2 weeks following), +/-lactic acid (risk stratification), +/- VBG (base deficit in acute setting), EKG (demand ischaemia), CT angio is test modality of choice for vascular cause of bleeding