GI Prophylaxis

Are ANY of the following major criteria below met?

Prior history of gastrointestinal bleeding or gastrointestinal ulceration within the past year
Mechanical ventilation > 48 hours or acute respiratory failure requiring BIPAP/high flow nasal cannula
Significant coagulopathy that is not medication induced: (INR > 1.5, platelets < 50,000/m3, aPTT > 2x control)
Hypoperfusion defined as:: Requiring vasopressor/inotrope support; Lactic acid ≥ 2 mmol/L
Admitted due to multiple trauma (ISS ≥ 16), traumatic brain, or spinal cord injury
Intracranial hemorrhage or ischemic stroke on this admission
Admitted due to acute major burn injury (> 20% of body surface area)
Atrial fibrillation ablation procedure in the last 30 days

If any of the following minor criteria apply, choose them, then follow the recommendation in the result section below:

NPO order
High daily dose corticosteroids (> 250mg hydrocortisone, >62.5mg prednisone, 50mg methylprednisolone, 9.375mg dexamethasone)
Two or more antiplatelet agents
- Antiplatelet agents include: aspirin, cilostazol, clopidogrel, prasugrel, ticagrelor, vorapaxar, anagrelide, cangrelor, and ticlodipine
ICU length of stay > 1 week
Systemic anticoagulation (excluding DVT [deep vein thrombosis] prophylaxis)
Post-op inpatient surgery
Hepatic failure/cirrhosis
Acute renal failure

Result:

NONE selected. GI prophylaxis is NOT indicated. Evaulate next day.

Additionally, patients should be continued on acid suppressive therapy if any of the following history exists in updated note documentation: