Management of acute gastrointestinal blood loss: summary of SIGN guidelines

Abstract

Acute gastrointestinal bleeding is a common major medical emergency, accounting for about 7600 admissions to hospitals each year in Scotland. Overall mortality of patients admitted to hospital because of acute gastrointestinal bleeding is 7%, rising to 26% in patients who bleed during admissions to hospital for other reasons.1 This article summarises the most recent guidance from the Scottish Intercollegiate Guidelines Network (SIGN) on the management of acute upper and lower gastrointestinal blood loss that is sufficiently severe to lead to emergency admission to hospital (see the full SIGN guidance, guideline 105, at www.sign.ac.uk). SIGN recommendations are based on systematic reviews of best available evidence, and the strength of the evidence is indicated as A, B, C, or D (fig 1)⇓. Recommended best practice (“good practice points”) based on the clinical experience of the guideline development group is also indicated (as GPP). Fig 1 Explanation of SIGN grades of recommendations ### Assessment and triage ### Models of care Admit acutely bleeding patients to a dedicated gastrointestinal bleeding unit in which there is appropriate monitoring …