<html>
<head>
<meta charset="UTF-8"/>
<meta name="tikaGenerated" content="true"/>
<meta name="date" content="2017-11-15T01:49:20Z"/>
<meta name="creator" content="Mary Dickson"/>
<meta name="xmp:CreatorTool" content="Acrobat PDFMaker 10.1 for Word"/>
<meta name="Company" content="SDGP"/>
<meta name="meta:author" content="Mary Dickson"/>
<meta name="meta:creation-date" content="2017-11-15T01:49:18Z"/>
<meta name="created" content="Wed Nov 15 12:19:18 ACDT 2017"/>
<meta name="dc:creator" content="Mary Dickson"/>
<meta name="xmpTPg:NPages" content="1"/>
<meta name="Creation-Date" content="2017-11-15T01:49:18Z"/>
<meta name="dcterms:created" content="2017-11-15T01:49:18Z"/>
<meta name="Last-Modified" content="2017-11-15T01:49:20Z"/>
<meta name="dcterms:modified" content="2017-11-15T01:49:20Z"/>
<meta name="Last-Save-Date" content="2017-11-15T01:49:20Z"/>
<meta name="meta:save-date" content="2017-11-15T01:49:20Z"/>
<meta name="SourceModified" content="D:20171114235832"/>
<meta name="Author" content="Mary Dickson"/>
<meta name="producer" content="Adobe PDF Library 10.0"/>
<meta name="modified" content="2017-11-15T01:49:20Z"/>
<meta name="Content-Type" content="application/pdf"/>
</head>
<body>
<pre>
 
 

Version Date from Date to Amendment 
2.1 Nov 2017 Nov 2019 Removed all RGH details 

 

OUTPATIENT GP REFERRAL GUIDELINES 
GASTROENTEROLOGY 

Southern Adelaide Local Health Network (SALHN) 
 

Haematemesis and Melaena 
 

 

Information Required  
  Focal gastrointestinal symptoms 
  Medications (antiplatelets, anticoagulation, NSAIDs) 
  Prior gastrointestinal surgery 

Investigations Required  
  FBE 
 

Fax Referrals to 
  Gastroenterology Outpatient Clinic 

Flinders Medical Centre 8204 5555 
 

 
 

 

Red Flags 
 Significant drop in postural BP (?20mmHg systolic, ?10mmHg diastolic) 
 Definite melaena 
 Hb &lt; 100gm/L 

 

Suggested GP Management 
Assess for significant drop in postural BP (?20mmHg 
systolic, ?10mmHg diastolic) which indicates 
haemodynamic instability 
 

Acute (haemodynamically unstable) 
  Intravenous fluid resuscitation 
  Keep patient fasted 
  Ambulance transfer to Flinders Medical Centre 

Emergency Department 
  Notify luminal Gastroenterology registrar on 8204 

5511 pager #38009 
 

Non-acute (haemodynamically stable) 
  Check FBE 
  Refer to Flinders Medical Centre Emergency 

Department and notify Gastroenterology Registrar on 
8204 5511 pager #38009 if 
o Definite melaena 
o Hb &lt;100gm/L or symptomatic  
o Age &gt;60yrs or history of significant comorbidity 
o Anticoagulated 

 

If Hb &gt;100gm/L and asymptomatic 
  Commence empirical proton pump inhibitor and 

refer urgently to Gastroenterology clinic 
 

Clinical Resources 
  Wee E. Management of nonvariceal upper 

gastrointestinal bleeding. J Postgrad Med [serial 
online] 2011 [cited 2014 Oct 20];57:161-7. Available 
from: http://www.jpgmonline.com/text.asp?2011/57/
2/161/81868 

 

 
 
 
 
Patient Information 
  UpToDate Patient information: GI bleed (The Basics)  

http://www.uptodate.com/contents/gi-bleed-the-
basics?source=search_result&amp;search=GI+bleed&amp;select
edTitle=1%7E150 

 

 
General Information to assist with referrals and the and Referral templates for FMC are available to download from the SAHN Outpatient Services 
website www.sahealth.sa.gov.au/SALHNoutpatients  

 








</pre>
</body>
</html>