EDUCATION PRACTICE Management of Patients With Nonvariceal Upper Gastrointestinal Bleeding

67-year-old man presents to the emergency room becauseof red blood hematemesis (twice over a 3-hour duration)and syncope. The patient was diagnosed 3 years ago withidiopathic atrial fibrillation and is taking only anticoagulants.He has no other significant past medical, surgical, or familyhistory. Furthermore, he has no allergies and does not smoke ordrink alcohol in excess. Upon physical examination, he wasactively throwing up large quantities of red blood. He has ablood pressure of 90/50 and a heart rate of 140. No signs ofcongestive heart failure were found. Laboratory data indicatedhe has a hemoglobin level of 9.5 g/dL, platelet level of 235 10