The following Sackler911 poll is now closed. Here are the
final results:


POLL QUESTION: A 51-year-old man is brought to the ED by EMS with a BP 90/60
mmHg, HR 110 beats per minute, RR 18 breaths per minute, and oxygen saturation
of 97% on room air. The patient tells you that he has a history of bleeding
ulcers. On exam, his abdomen is tender in the epigastric area. He is guaiac
positive (pressence of fecal occult blood) with black stool. He has a bout of
hematemesis (vomiting blood) and you notice that his blood pressure is now 80/50
mm Hg, HR is 114 beats per minute, and the patient is starting to drift off.
Which of the following is the most appropriate next step in therapy?

CHOICES AND RESULTS
- Assess airway, establish two large-bore IVs, cross-match for two units of
blood, administer 1-2 liters of normal saline, and schedule an emergent
endoscopy, 6 votes, 100.00%
- Assess airway, establish two large-bore IVs, crossmatch for two units of
blood, and administer a proton pump inhibitor, 0 votes, 0.00%
- Place two large-bore IVs, crossmatch for two units of blood, administer a 1-2
liters of normal saline, and schedule an emergent endoscopy, 0 votes, 0.00%
- Intubate the patient, establish two large-bore IVs, cross-match for two units
of blood, administer a 1-2 liters of normal saline, and schedule an emergent
endoscopy, 0 votes, 0.00%
- Intubate the patient, establish two large-bore IVs, crossmatch for two units
of blood, and administer a proton pump inhibitor, 0 votes, 0.00%



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