GI Bleed services in Ireland : a hospital based Survey from the GI registrar and Specialist Registrars
Pardeep K Maheshwari , Carol A Gould
Department of Gastroenterology, Galway University Hospitals.
GI Bleed is very common medical emergency. According to British society of Gastroenterology (BSG) , even after the lot of progress in GI bleed management there is still significant hospital mortality rate around 10%. To assess the GI Bleed services in Ireland we performed a hospital based survey.
To assess the GI bleed Services of Ireland.
We developed a 10 question based Survey monkey and contacted the GI registrars and Specialist Registrars Via email. We received 30 replies which almost covered all the major hospital of Ireland. From some hospital more than one person participated in the survey. The data was exported to the excel sheet for the calculations.
Of those who replied 93% replied as no formal rota for the GI bleeder management , 20 % replied they have their endoscopy unit open out of hours for the emergencies . For the endoscopy timing 83 % agreed that OGD is performed within 24 hours of the admission . For the assessment of the severity of the emergencies 40 % don't use any formal scoring and 36% only the Glasgow Blatchford score for upper GI bleed. Use of PPI infusion as pre endoscopy is still very common as 56% replied they use the infusion 33% replied as not used always and only 6% said they don't use the PPI infusion. The use of prokinetic agents to clear the gut for better visualization is very uncommon as only 13% use IV Erythromycin pre-endoscopy. Fifty six percent of the replies said they don't have any formal guideline for the management of the Upper GI bleed ,while for the quality assurance and improvement only 46% replied that their hospital unit performs the audit . Some hospital has more the one respondents and when we compare their replies there was clear discrepancies in the replies.
Looking at the above results it can be concluded that for management of the such a significant medical emergency there is no uniform guideline in the Ireland . There are discrepancies in the formal assessment of the severity. More interesting part of the results is there were discrepancies in the replies form the same hospital suggest that these guideline are not properly communicated to the