Clinical and Experimental Gastroenterology (Apr 2023)
A Novel Multidisciplinary Team Activation for Patients with Severe Gastrointestinal Bleeding: Creation of the Code GI Bleed Protocol
Abstract
Christopher W Baugh,1 Aaron D Sodickson,2 Sean M Kivlehan,1 Paul C Chen,1 Molly L Perencevich,3 Arun B Jesudian4 1Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 2Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 3Division of Gastroenterology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 4Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USACorrespondence: Christopher W Baugh, Brigham and Women’s Hospital, Department of Emergency Medicine, 75 Francis Street, Neville House 2 nd Floor, Boston, MA, 02115, USA, Tel +1 617-732-8192, Fax +1 617-264-6848, Email [email protected]: Patients with gastrointestinal (GI) bleeding present to the emergency department (ED) with a wide spectrum of illness severity. Among the most critically ill patients, comorbidities and other risk factors, such as liver disease and anticoagulation, can complicate their management. These patients are resource-intensive to stabilize and resuscitate, often requiring the continuous attention of multiple ED staff members along with rapid mobilization of specialty care. At a tertiary care hospital with the ability to provide definitive care for the most critically ill patients with GI bleeding, we introduced a multi-disciplinary team activation pathway to bring together specialists to immediately respond to the ED. We designed a Code GI Bleed pathway to expedite hemodynamic stabilization, diagnostics, source control, and timely disposition out of the ED to the intensive care unit or relevant procedural area of the hospital.Keywords: emergency, gastrointestinal bleeding, endoscopy, gastrointestinal hemorrhage, critical care
