Emergency GI Sheet
for bleeding esophageal varices

(The following was provided by Dr. David Piccoli, Division Chief, Pediatric Gastroenterology and Nutrition, at The Children's Hospital of Philadelphia.)

If your child has portal hypertension and esophageal varices and:
1) Vomits blood,
2) Vomits brown or black material which resembles coffee grounds, OR,
3) Has a black, tarry or bloody stool

Please follow these instructions:

• Notify your doctor immediately. 
• Go to the nearest Emergency Room or hospital, take this sheet with you.
• Inform the doctor there of your child's condition.  They should:          
  
  Place large bore IV and draw the following: 
       -CBC with differential
       -Platelet Count
       -Reticulocyte count
       -PT/PTT
       -Type and cross for 2 units PRBC minimum
  
  Insert a nasogastric tube into the stomach, lavage with room temperature normal saline to verify the presence of blood.  Leave tube in place.
  
  For more on "Clinical Care Considerations", see Disease Detailed Facts - beginning on page 7.