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29 Acute gastrointestinal bleed (GI) management services in ireland: a hospital based survey
  1. P Maheshwari,
  2. M Ashfaq,
  3. S Palaniappan,
  4. C Goulding
  1. 1Beaumont Hospital Dublin, Ireland
  2. 2Galway University Hospital Galway, Ireland

Abstract

Background Upper GI bleed (UGIB) is very common medical emergency and despite significant progress in its management it still carries a mortality of up to 10%. In order to assess the current management of UGIB in Ireland we performed a hospital based survey.

Aim In order to assess the current management of UGIB in Ireland we performed a hospital based survey.

Method We developed a 10 question based Monkey Survey and contacted all the Gastroenterology registrars and specialist registrars in Ireland.

Results Out of 26 hospitals contacted, 22 replied. From some hospitals we received more than one reply. Of those who replied 56% had no hospital guidelines and 96% had no formal rota for the management of UGIB and only 20% had access to their endoscopy unit out of hours. Endoscopy was performed within 24 hours of admission in 83% of cases. A formal Severity Assessment Score was used by 60%, with 36% using the Glasgow Blatchford Score. Pre-endoscopy 56% gave PPI infusions, while 6% said they never used them pre-procedure. Only 13% used IV erythromycin as a prokinetic agent. Where we received more than 1 reply from some hospitals there were discrepancies in those replies suggesting a lack of uniform approach internally.

Conclusions From the above results its can be concluded that there is a significant lack of guidelines for the management of UGIB, despite the high mortality it carries and even within the same hospital its management varies significantly. This survey high-lights the need for formal guidelines for UBIG to be introduced.

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