NOTE: The tool applies to patients with acute upper or lower gastrointestinal hemorrhage.
Parameters:
(1) hemodynamically stability on admission to the ICU
(2) requirement for vasopressors
(3) other organ system failures
(4) evidence of active, on-going gastrointestinal hemorrhage at time of triage
A patient is considered hemodynamically stable if both the following are present:
(1) mean arterial pressure > 60 mm Hg
(2) systolic blood pressure > 100 mm Hg
An organ failure for a body system is a disease that usually requires intensive care (such as acute myocardial infarction, major stroke, liver failure, renal failure, etc.).
Active on-going gastrointestinal bleeding involves one or more of the following:
(1) blood red hematemesis
(2) blood red nasogastric lavage
(3) bright red blood per rectum (not due to hemorrhoids)
|
Parameter
|
Finding
|
Points
|
|
hemodynamic stability
|
stable
|
0
|
|
|
unstable
|
1
|
|
vasopressors
|
not required
|
0
|
|
|
required
|
1
|
|
other organ failures
|
absent
|
0
|
|
|
present
|
1
|
|
active GI bleeding
|
absent
|
0
|
|
|
present
|
1
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A patient is classified as low risk if the score is 0, else classified high risk (scores 1 to 3).
