Don't panic when bleeding, just move around! Recovery tips for patients with upper gastrointestinal bleeding

Author: Zhang Haiyan, The Fifth Medical Center, PLA General Hospital

Reviewer: Jin Bo, Chief Physician, Fifth Medical Center, PLA General Hospital

Upper gastrointestinal bleeding is not only the abnormal outflow of blood from the esophagus, stomach, duodenum and other parts of the upper gastrointestinal tract, but also an emergency warning signal sent by the body to us. The occurrence of this disease is often accompanied by serious health hazards. From anemia, shock to life-threatening emergencies, every step cannot be ignored. What is particularly critical is that the mobility of patients with upper gastrointestinal bleeding will be restricted to varying degrees during the treatment process. From strict bed rest during the acute attack period to gradually increasing the amount of activity during the recovery period, every stage requires patients and their families to strictly follow the doctor's instructions and requirements. This is because improper activities may aggravate bleeding, affect wound healing, and even cause more serious complications. Therefore, understanding and following the activity norms of patients with upper gastrointestinal bleeding at different stages is of great significance to promoting the stability of the disease and accelerating the recovery process.

1. Why is it forbidden to get out of bed to urinate or defecate during upper gastrointestinal bleeding?

1. When bleeding occurs, the patient should absolutely stay in bed to avoid changes in abdominal pressure that may lead to changes in portal vein pressure and increase the risk of rebleeding.

2. Patients with bleeding often experience symptoms such as dizziness and fatigue due to insufficient blood volume. They may experience orthostatic hypotension and fainting due to changes in body position, increasing the risk of falling or falling out of bed.

2. How to move during the recovery period of upper gastrointestinal bleeding?

Patients should ensure adequate sleep and a regular daily routine. After the bleeding stops, as the condition improves, they can sit up first. When they are no longer dizzy, they can get up and move around the bed. They can go to the toilet with the help of a dedicated person. After their physical strength is restored, they can gradually increase their activity level, without increasing fatigue and other symptoms. It should be noted that the activity should be slow, and three "30 seconds" should be achieved (after waking up, lie in bed for 30 seconds before sitting up, sit up for 30 seconds before standing up, and stand for 30 seconds before walking).

3. What should you pay attention to during activities during the recovery period of upper gastrointestinal bleeding?

The patient is relatively weak after bleeding, and has been bedridden for a long time, with weakness in both lower limbs. It is recommended that he rest in bed. If he moves rashly, the risk of falling will increase.

Figure 1 Copyright image, no permission to reprint

4. What are the consequences of falling or falling out of bed?

The possible consequences of falling or falling out of bed include trauma, fractures, internal bleeding, and even death. While increasing the patient's pain and family burden, it can also easily lead to unnecessary medical disputes.

5. Who are the high-risk groups for falls or falling out of bed?

People at high risk of falling or falling out of bed include patients with limited mobility, a history of falls, impaired consciousness, movement disorders or visual impairment, patients taking medications that affect consciousness or activity, such as sedatives, hypnotics, laxatives, diuretics, etc., patients with anemia or hypoglycemia, malnutrition, weakness or dizziness.

6. What are the factors that lead to falls or falling out of bed?

The factors that lead to falls or falling out of bed are divided into internal factors and external environmental factors.

1. Intrinsic risk factors

(1) Physiological factors: Gait and balance function, damage and degeneration of the sensory system, central nervous system and skeletal muscle system are common causes of falls in the elderly.

(2) Disease factors: Disease and its accompanying symptoms increase the probability of falls, such as fatigue, decreased vision or hearing, bone and joint pain, etc.

(3) Drugs and adverse reactions: antihypertensive drugs, hypoglycemic drugs, diuretics, sedatives and cardiovascular drugs, etc.

(4) Psychological factors: Depressed mood and poor mental state also increase the risk of falling.

(5) The patient himself: wearing clothes that are too big, wearing inappropriate shoes, such as disposable cloth slippers, or standing up too quickly, causing fainting.

2. External environmental factors

(1) Ward environment: slippery and uneven floor, dim lighting, obstacles on the way, inappropriate furniture height and placement, etc.

(2) Bathroom facilities: The basic facilities to prevent people from falling out of bed are insufficient, and there are steps that can easily cause people to trip.

7. How to prevent falls or falling out of bed?

1. When moving, you should assess the surrounding environment to see if there are any obstacles, and stay close to the handrails on both sides of the corridor when moving.

2. Patients who have difficulty in moving, are weak or unable to take care of themselves, or have decreased vision should ask family members to accompany them when they go out and assist with activities.

Figure 2 Copyright image, no permission to reprint

3. When getting out of bed, please get up slowly and do three 30-second stretches (i.e., lie in bed for 30 seconds after waking up and then sit up, sit up for 30 seconds and then stand up, stand for 30 seconds and then walk). This principle should be followed especially when taking certain special medications, such as antihypertensive drugs, diuretics or hypnotics.

4. Keep the lights in the ward and corridors bright to make it easier for patients to move around. Do not lock the door when going to the toilet, and squat and stand up slowly.

5. Keep the floor dry. If the floor is slippery, ask the staff to deal with it in time and place a non-slip mat in the bathroom.

6. Store large items such as luggage in the cabinet, keep walking aisles clear, and place other commonly used daily necessities in easily accessible places.

7. Please pull up the bed rails when lying in bed, especially when the patient is restless and unconscious.

8. Wear clothes and shoes of appropriate size. If clothes are too long, roll them up to avoid tripping. Avoid wearing disposable slippers.

9. When you need assistance, press the call bell in time and the nurse will come to you.