A 50-year-old male patient with a known history of cirrhosis is brought to the emergency department with hematemesis. On assessment, his blood pressure is 90/60 mmHg, heart rate is 122 bpm, and he appears pale and diaphoretic. Which immediate intervention is most appropriate for this patient?
Start an infusion of proton pump inhibitor
Initiate IV crystalloid fluid resuscitation and monitor hemodynamic status
Perform immediate endotracheal intubation
Administer a beta-blocker to reduce portal hypertension
In a patient with suspected bleeding esophageal varices, as indicated by hematemesis and a history of cirrhosis, the priority intervention is volume resuscitation to maintain hemodynamic stability. This is typically initiated with the administration of IV crystalloid fluids. Endotracheal intubation may be necessary if the airway is at risk, but it is not the first immediate intervention. The administration of beta-blockers is a long-term management strategy for esophageal varices to reduce the risk of bleeding, not an acute intervention. While proton pump inhibitors may be used in gastrointestinal bleeding, they are not the primary treatment for bleeding esophageal varices.
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Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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