History

Presenting bleeding pattern

Bleeding pattern

OPQRST

Associated symptoms

Symptom context and trajectory

Context and trajectory

Alarm Features

Hemodynamic and shock triggers

Shock triggers

High risk bleeding contexts

High risk contexts

Red flags for alternate diagnoses

Alternate diagnosis red flags

Medications

Bleeding and platelet effect

Bleeding risk meds

Infection and colitis risk

Colitis risk meds

Medication planning constraints

Constraints

Diet

Recent intake and hydration

Intake and hydration

Foodborne exposure

Review of Systems

Constitutional and infection

Constitutional

Cardiopulmonary and anemia

Anemia and cardiopulmonary

GI and rectal symptoms

GI and rectal

Collateral History and Family History

Collateral and reliability

Collateral

Family history relevant

Family history

Risk Factors

Lower GI bleeding etiologies

Etiology risk factors

Ischemia and vascular risk

Ischemia risk

Infectious and inflammatory risk

Colitis risk

Differential Diagnosis

Life threatening

Common

Less common and mimics

Less common

Past Medical History

Prior GI evaluation and interventions

GI history

Comorbidities affecting management

Comorbidities

Physical Exam

Initial appearance and perfusion

General and perfusion

Hemodynamic exam

Hemodynamic

Abdominal exam

Abdominal

Rectal and perianal exam

Rectal and perianal

Lab Studies

Core labs for bleeding severity

Core labs

Additional labs by context

Context labs

Stool and infection labs

Stool labs

Imaging

Scoring Systems

Risk scores

MRI

CT

Ultrasound

Special Tests

Bedside evaluation and procedures

Bedside and procedures

Endoscopy and angiography pathways

Specialty diagnostics

ECG

Indications in GI bleeding

ECG indications

High risk ECG patterns

High risk patterns

Assessment

Problem representation and severity

Severity

Source localization logic

Localization

Complications to rule out

Complications

Plan

First 5 minutes

Transfusion and hemostasis strategy

Hemostasis strategy

Diagnostic sequencing

Therapeutics by suspected cause

Therapeutics

Reassessment loop

Disposition

ICU criteria

Inpatient and observation criteria

Inpatient and observation

Discharge criteria

Discharge Instructions

Copy discharge instructions

References

Guidelines and key sources

References