He was connected to vital monitors which were not reassuring. What is the management?

An elderly male pt with prior hx of hematemesis is having hx of long term use of aspirin and
other drugs, now presents with severe epigastric pain, dysphagia and vomiting. He was
connected to vital monitors which were not reassuring. What is the management?

a. Oral antacids
b. IV PPI
c. Oral PPI
d. Endoscopy
e. Analgesia

Ans. The key is D. Endoscopy. [Long term use of an nsaid predisposes to peptic ulcers. There may cause considerable bleeding leading to shock