TCA Overdose
play_arrow TCA Overdose Dr Swapnil Pawar TCA Toxicity Blog Written by Dr Andrew Lam ECG Findings in TCA Toxicity Tachycardia Widened QRS Complex Deep S wave in Lead I and […]
Remifentanyl Vs Fentanyl Dr Swapnil Pawar
Analgesics Dr Swapnil Pawar
Effects of the sudden and sustained increase in LV Afterload Dr Swapnil Pawar
Haemtemesis
Dr Swapnil Pawar
Scoring systems are helpful in identifying patients who are low risk for rebleeding or mortality, and therefore can be considered for outpatient management
Glasgow-Blatchford Score
Glasgow Blatchford Score does not take endoscopic data into account so it can be calculated when the patient first presents. It is considered to be of low risk when the total score is 0. Any score higher than 0 is indicative of requiring intervention, whether that be transfusion, endoscopy or surgery.
Glasgow-Blatchford Score | |
BUN (mmol/L) | |
<6.5 | 0 |
6.5-8 | +2 |
8-10 | +3 |
10-25 | +4 |
>25 | +6 |
Haemoglobin (g/L) for men | |
>130 | 0 |
120-130 | +1 |
100-120 | +3 |
<100 | +6 |
Haemoglobin (g/L) for women | |
>120 | 0 |
100-120 | +1 |
<100 | +6 |
Systolic blood pressure (mm Hg) | |
≥110 | 0 |
100–109 | +1 |
90–99 | +2 |
<90 | +3 |
Other criteria | |
Pulse ≥100 (per min) | +1 |
Melena present | +1 |
Presentation with syncope | +2 |
Liver disease history | +2 |
Cardiac failure present | +2 |
Rockall score
The Rockall score was developed to give a percentage risk of rebleeding and total deaths. It .can be used to stratify patients who may need intensive care but is less accurate in identifying low-risk patients that can be managed as an outpatient.
With a score of 0-1, there is a 0% mortality and at a score of 2, there is a 0.2% mortality risk.
Rockall Score | |
Age (years) | |
<60 | 0 |
60-79 | +1 |
>80 | +2 |
Haemodynamic Shock (SBP + HR) | |
NO SHOCK | 0 |
Tachycardia (HR >100 but SBP > 100) | +1 |
Hypotension (SBP <100) | +2 |
Major Co-Morbidities | |
None | 0 |
Any EXCEPT (1) renal failure (2) liver failure) (3) disseminated malignancy | +2 |
(1) renal failure (2) liver failure) (3) disseminated malignancy | +3 |
Diagnosis (endoscopy) | |
Mallory Weiss Tear | 0 |
No lesion/no stigmata or recent haemorrhage | 0 |
All other diagnosis | +1 |
Malignancy of upper GI Tract | +2 |
Major stigmata of recent haemorrhage (endoscopy) | |
Dark spot only | 0 |
Blood in upper GI tract | +2 |
Adherent clot | +2 |
Visible or spurting vessel | +2 |
Approach to acute upper gastrointestinal bleeding in adults [updated 2021 October]. In: Therapeutic Guidelines [digital]. Melbourne: Therapeutic Guidelines Limited; 2022 Jan. <https://www.tg.org.au>
Dr Swapnil Pawar January 31, 2022
play_arrow TCA Overdose Dr Swapnil Pawar TCA Toxicity Blog Written by Dr Andrew Lam ECG Findings in TCA Toxicity Tachycardia Widened QRS Complex Deep S wave in Lead I and […]
Dr Swapnil Pawar September 13, 2024
Dr Swapnil Pawar August 1, 2024
©Allrights reserved. Get Your Web Site Designed By St.George Web Design. Get a quote on your web design.