This guideline is aimed at secondary care and bleeding from peptic-ulcers or varices. Bear in mind, that this doesn’t really look at management of other causes of bleeding, like Mallory-Weiss tears and oesophagitis as there isn’t much research on these and bleeding is normally self-limiting and less serious.
Basically our hospital colleagues should be risk-scoring patients before endoscopy using the Blatchford Score and post endoscopy using the Rockall Score . Neither of these are validated for use in primary care.
All patients with upper GI bleeding should have endoscopy within 24hrs (if the unit is big enough to provide the service). Therefore, the implication is that we should be referring everyone you suspect of upper GI bleeding from a peptic-uler or oesophagitis.