Hemodynamic monitoring is instituted and airway control is assured.
Patients who are vomiting blood or are restless undergo endotracheal intubation and ventilator support. Light sedation is induced with drug of choice intravenously. Less than 1 cc of sclerosant is used per injection. The pattern of injection is standardized so that each distal esophageal varix is injected at the gastroesophageal junction and about 2.5 cm and 5 cm above the gastroesophageal junction. Descriptive data on the findings at EGD and sclerotherapy are recorded on a standardized form.