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Gastrointestinal bleeding has a profound impact on public health due to its high prevalence and severity. With the elderly population taking more anticoagulants/antiaggregants/non-steroid anti-inflammatory drugs, the digestive bleeding will certainly raise more and more challenges in quantity as well as in severity for the public healthcare system. The emergency medicine specialists and gastroenterologists have a central role in the management of patients presenting with gastrointestinal bleeding. In certain cases, radiologists, invasive radiologists, intensive care specialists and surgeons should also be involved in the decision making process and management of patients. Therefore, Hungarian experts felt the need to elaborate a comprehensive, multidisciplinary, practical local guideline reflecting the frequently arisen aspects based on current international guidelines. This guideline proposal covers topics of basic requirements, initial assessment of patients, risk evaluation, laboratory tests, hemodynamic resuscitation in the case of gastrointestinal bleeding followed by its consecutive steps of diagnosis and therapy sorted by location of the source of the hemorrhage. The authors give practical instructions for unsuccessful hemostasis or rebleeding. Finally, the role of surgery is also summarized in the management of gastrointestinal bleeding. Orv Hetil. 2020; 161(30): 1231-1242.

Quality expectations of emergency medicine are not fully formed yet. However, client satisfaction examinations proved to be a valid tool for assessment of different parts of medical care. To define process parameters turning to efficiently expand of maintenance-quality the authors developed and applied a client satisfaction questionnaire in Szent Imre Hospital Emergency Department. Answers for client satisfaction questionnaire collation of characteristics of patients' demographic data, sociological situation, and quality of life were studied by multinomial regression analysis in a prospective pilot study. The returned questionnaires were represented in 28% of the examined patient group. To achieve the greatest improvement in patients satisfaction, painkilling, patients information, and inter-relationship between patients and providers would be corrected in the emergency department. Compound client satisfaction questionnaire was proved to be a susceptible tool for identified the relevant pars of the process quality.