Impending bleeding doom

  • Escalate early (to whichever specialty should be stopping the bleed)
  • Right place - resus, and on to theatre? IR?
    Vasc access and bloods:
  • 2x large bore cannula
  • Crossmatch, FBC, coag screen, VBG, LFT
    Haemostatic rescuscitation:
  • TXA (not for UGIB/peptic ulcer disease)
  • Correct coagulopathy
  • Anticoagulant reversal
    Optimise clotting: keep warm, aim iCa >1.1 (10ml 10% Ca gluconate PRN)

See Massive haemorrhage