Medical

GI bleed / hematemesis airway

Before / During / After / Pitfalls

Before

  • Resuscitate hemorrhagic shock: blood products/access/pressor only as bridge per protocol.
  • Two suctions and dirty-airway strategy ready; anticipate ongoing emesis.
  • Assign blood/pressor and airway roles separately.

During

  • Suction continuously and avoid advancing through pooled blood.
  • Consider head-up/positioning as physiology allows.
  • Confirm tube with EtCO2 and secure despite ongoing contamination.

After

  • Continue hemorrhage control, endoscopy/IR pathway, ventilator and shock reassessment.
  • Sedation/analgesia and aspiration management.
  • Debrief suction strategy and failed-attempt prevention.

Pitfalls

  • One suction catheter only.
  • Airway team distracts from hemorrhage resuscitation.
  • No plan for re-contamination after successful tube.

Educational resource only. Use institutional protocols, local policy, and bedside clinical judgment.