31st July 2023

A 76-year-old man attends A&E, and it is immediately apparent he is unwell

A 76-year-old man attends A&E, and it is immediately apparent he is unwell. He reports feeling dizzy, having severe abdominal pain, and appears confused. His wife tells you he mentioned having had some unusually dark stools that morning. He has a past medical history of moderate aortic stenosis and drug eluting stent for coronary artery disease. He takes aspirin, clopidogrel, simvastatin, metoprolol, and lisinopril.

His BP is found to be very low, and so he is resuscitated with normal saline and a unit of red blood cells. His vitals improve to: BP 123/78 mmHg, HR 98 bpm, RR 18, T 37.6oC and saturating well on room air.

What is the next step of management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.