Upper gastrointestinal bleeding
Assess haematemesis or melaena and understand the priorities before specialist treatment.
Clinical learning outcomes: Awaiting named clinical review.
What you should learn
- Recognise instability and escalate promptly.
- Discuss upper-GI causes, risk factors and initial assessment.
Recognise and explain
- Distinguish likely variceal and non-variceal causes without assuming the source is already proven.
On your placement
Agree the activity and supervision with the clinical team. For patient-facing learning, seek permission and respect the patient’s comfort and care needs.
- Take a bleeding, liver disease and medication history.
- Review observations and blood results with your supervisor.
- Follow the resuscitation and endoscopy referral plan.
Start here
MLA: gastrointestinal history
Take a focused bleeding and gastrointestinal history.
MLA: assess, act and reassess
Review initial assessment and escalation for the shocked patient.
Current guidance
NICE CG141: upper gastrointestinal bleeding
Read initial assessment, resuscitation and endoscopy timing for people aged 16 and over; discuss how the patient’s condition changes urgency.
Discuss
Initial assessment of upper gastrointestinal bleeding
Contrast a shocked patient with a stable low-risk presentation to practise resuscitation, escalation and reliable follow-up.
On your next shift
Ask how ongoing bleeding altered the timing of specialist treatment.
Go deeper
Optional material. Advanced resources extend discussion; they do not define independent student practice. Check the publication date and compare clinical advice with current guidance.
GMC: procedure supervision and graduate requirements
Check the competence and supervision level for a procedure; agree what you can practise with your placement supervisor.
How this relates to GMC graduate outcomes and the MLA
These are St Emlyn’s learning connections, not a claim that this page covers every national requirement.
Presentations and conditions: Haematemesis; Melaena.
Clinical and professional capabilities: Assessment and clinical reasoning; Recognising limits and seeking help.
Practical skills: IV cannulation under direct supervision.
St Emlyn’s interpretation of relevant GMC graduate outcomes and MLA themes; these are summary labels, not official topic codes or a complete curriculum.
Explore the student placement programme
Student practice and graduate expectations
About this resource and its review
A St Emlyn’s guide to learning Emergency Medicine during undergraduate placements. It is not an official medical-school or GMC curriculum. Your medical school’s curriculum and assessment requirements take precedence.
National foundations: GMC Outcomes for Graduates, the practical-skills supplement and the MLA content map applying from September 2026.
Framework checked: 8 October 2026. This is a source check, not clinical sign-off.
Clinical learning outcomes: awaiting named clinical review.
The four learning routes are St Emlyn’s groupings. The six interconnected MLA domains remain part of the official content map.