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Consult: GI for Stable UGI Bleed

Call the GI fellow about a stable patient with an upper GI bleed to discuss the appropriate timing for endoscopy.

  1. 1
    Briefing
  2. 2
    Simulation
  3. 3
    Feedback

How This Works

This is an interactive phone call simulation. You'll speak with Dr. Miller in a realistic clinical communication scenario.

1. Start Call

Click "Start Call" when you're ready. Speak naturally as you would on a real call.

2. Have the Conversation

10 minutes to complete the call. The AI responds in real-time to what you say.

3. Get Feedback

End the call when finished. You'll receive AI-powered feedback on your communication.

💡 Tip: Speak clearly and at a natural pace. If you need a moment to think, it's okay to pause briefly - just as you would in a real conversation.

Briefing Details

Consult Briefing

Your Objective

You are the hospitalist caring for a patient admitted with an upper GI bleed who is now hemodynamically stable. Your objective is to call the on-call GI fellow, Dr. Miller, to discuss the case and the appropriate timing for an endoscopy (EGD). Be prepared to provide the key data points they will need to risk-stratify the patient.

Patient: Frank Wright, 62M

  • Room: 705
  • Code Status: Full Code

Case Summary & Data

History: 62M with a history of alcohol-associated cirrhosis and hypertension presented to the ED after one episode of hematemesis (vomiting blood) and several episodes of melena (black, tarry stools). He was hypotensive on arrival.

Hospital Course: He received IV fluids, 1 unit of packed red blood cells, and was started on a proton-pump inhibitor (PPI) drip. His vital signs have stabilized, and he has had no further hematemesis or melena in the last 6 hours.

Pertinent Data:

  • Vitals: BP 110/70, HR 85 (on arrival was 90/50, HR 115).
  • Labs: Hemoglobin on admission was 7.2. After 1 unit of blood, it is 8.5. Platelets are 90 (low due to cirrhosis).

The Clinical Question

You have a stable patient with a high-risk upper GI bleed (due to his cirrhosis and varices risk). The question is not *if* he needs an EGD, but *when*.

Your "Ask": Your specific question for the GI fellow is: "I have a stable patient with a variceal bleed concern who has been resuscitated. I'm calling to discuss the timing of endoscopy. Does he need an emergent EGD tonight, or can this wait for the morning list?"

Learning Objectives

Optional prep details

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Optional Pre-Call Knowledge Check

Optional self-check before you start

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After completing this scenario, you will be able to:

  • Synthesize patient data into a concise SBAR format for a GI consultation.
  • Apply a clinical risk stratification score (e.g., Glasgow-Blatchford) to a patient with an upper GI bleed to recommend appropriate timing for endoscopy.
  • Formulate a clear clinical question for the consultant regarding the timing of endoscopy for a stable upper GI bleed.

Which of the following clinical factors is NOT a component of the Glasgow-Blatchford Score (GBS) for risk-stratifying upper GI bleeds?

According to current guidelines, a hemodynamically stable patient with an upper GI bleed and a very low-risk score (e.g., GBS ≤ 1) can often be managed with which approach?

When calling a GI consult for a stable upper GI bleed, which of the following lab values is most critical to have readily available to discuss risk?