ocr: 1. Define the site, source, and cause. Consider the less invasive thera- peutic alternatives. Hematemesis is almost always from the stomach, duodenum, or most-proximal jejunum. Pass nasogastric or larger-bore orogastric tube to evacuate clot. Pertorm upper gastrointestinal endoscopy. Consider injection, electrocoagulation, photocoagulation for le- sions ofa acid-peptic disease, gastritis, Mallory-Weiss tear, or sclero- therapy for varices. Melena or bright red blood around the rectum. Perform sigmoidos- copy to rule out source in distal 25 cm of colon if no blood is found in nasogastric aspira ...
