ABSTRACT
A 65-year-old patient with a history of advanced metastatic carcinoma of the bowel was admitted to hospital with a deterioration in his general condition. An
ultrasound of the abdomen confirmed liver metastases. With nursing care his condition started improving again but 6 days postadmission he had a massive rectal bleed and was noted to be cold, clammy, and hypotensive. He was conscious and anxious.
