Approach to vomiting (acute) Quiz: Ace Your Exams
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A 58-year-old man is brought to the emergency department by paramedics after multiple episodes of large hematemesis over the past 30 minutes. He has a history of alcohol use disorder and cirrhosis. He was found confused and drowsy at home, and his family called emergency medical services. In the emergency department, he appears lethargic and moans in response to painful stimuli. Temperature is 37°C (98.6°F), blood pressure is 85/60 mmHg, heart rate is 125 beats per minute, respiratory rate is 24 breaths per minute, and oxygen saturation is 89% on room air. Physical examination reveals pallor, diaphoresis, spider angiomas, abdominal distention with a fluid wave, and melena on the rectal exam. Which of the following is the most appropriate next step in management?
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