For patients with gastrointestinal bleeding, how do you decide which patients to send to the floor & which to send to the ICU?

BLEED tool
Kollef MH, et al. BLEED: a classification tool to predict outcomes in patients with
acute upper and lower gastrointestinal hemorrhage. Crit Care Med. 1997 Jul;25(7):

  • B visualized red blood (hematemesis, nasogastric lavage, or per rectum other than clinically assessed self-limited hemorrhoidal bleeding)
  • L low systolic blood pressure (< 100 mm Hg)
  • E elevated prothrombin time (>1.2 times the control value)
  • E erratic mental status
  • D unstable comorbid disease (i.e., any condition normally requiring admission to ICU

465 patients admitted through ER for upper or lower GI bleeding.  Classified as high or low risk based on these criteria.  Results include risk of in-hospital complications for high and low risk patients.

Repost from 9/25/09


About Amy

Clinical Informationist at EUH Branch Library
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