Overview
Clinical Orientation
A GI bleed is a perfusion problem before it is a stool colour problem.
A GI bleed is a perfusion problem before it is a stool-colour problem. Blood loss can reduce circulating volume and oxygen delivery while the first hemoglobin result still appears normal; with upper bleeding, blood and vomitus also create an immediate aspiration risk. The bleeding pattern helps locate the source, but hemodynamic status determines the first action. A patient with bright red rectal bleeding and shock may have a rapid upper bleed, so the nurse stabilizes the patient before assuming that the source is lower or sending the patient for a routine diagnostic procedure.