ABSTRACT
IS THE PATIENT’S LIFE AT RISK? ■ If the following abnormalities exist, call for backup and do
not let the diagnostic work-up delay stabilization of the patient: ▲ Vital signs-tachycardia, hypotension ▲ General appearance-pallor, cold and clammy appearance ▲ Mental status changes or confusion ▲ Obvious large bleeding site ▲ Bleeding from numerous sites
ADDRESSING THE RISK ■ For serious or life-threatening bleeding
▲ Secure the airways. ▲ Obtain venous access-two large-bore peripheral IVs. ▲ Start fluid resuscitation with 0.9 isotonic saline, and order
emergency RBCs. ▲ Give nasal oxygen if intubation is not necessary. ▲ Obtain a priority type and crossmatch, CBC, aPTT, PT, and
fibrinogen to assess the degree of bleeding and to screen for coagulopathy.
