UrgentEmergency Guide
Blood in vomit: Red Flags & Emergency Signs
Vomiting blood is a medical emergency — variceal bleeding and peptic ulcer haemorrhage carry 10–15% in-hospital mortality without prompt endoscopy and haemostasis.
🚨 Call 999 / 112 Immediately
- ⚠Vomiting fresh bright-red blood — active upper GI haemorrhage, call 999
- ⚠Vomiting coffee-ground material — upper GI bleed (slower rate)
- ⚠Haematemesis with hypotension and tachycardia — haemorrhagic shock
- ⚠Haematemesis in a patient with known liver disease — variceal bleeding (terlipressin + antibiotics + urgent endoscopy)
⚡ See a Doctor Today
- •Any haematemesis requires hospital admission, IV access, and urgent endoscopy
High-Risk Combinations
When blood in vomit occurs together with any of these symptoms, urgency increases significantly:
Conditions to Rule Out Urgently
Oesophageal Varices (Portal Hypertension)urgent
Terlipressin; IV ciprofloxacin; urgent OGD; Sengstaken tube if refractory
Peptic Ulcer Haemorrhage (Forrest Ia/Ib)urgent
PPI infusion; OGD within 24 hours; Rockall score
Mallory-Weiss Tearurgent
Retching/vomiting preceded haematemesis; OGD; usually stops spontaneously
When to Call Emergency Services
- →Any vomiting of blood — always an emergency