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71 Clinic. The hidden period is characterized by signs of violation of intra-abdom- inal circulation: there is weakness, dizziness, noise, ringing in the head, nausea, sweating, fainting, abdominal pain disappear. The second period is the period of profuse hemorrhage – an episode of bloody vomiting or vomiting the color of coffee grounds and the appearance of melena (liquid, tar-like stool). The most reliable signs of gastrointestinal bleeding are hematemesis (lat. Hae- matemesis – bloody vomiting) and melena (Greek. melanos – dark, black) – tar- like, black liquid stool. Depending on the location of the source of bleeding, feces can have a variety of colors: from black to scarlet. The black color of feces is due to the presence of hematin hydrochloric acid, which is formed from hemoglobin under the influence of hydrochloric acid of gastric juice. The higher the source of bleeding, the more altered is the blood released with feces. When gastric bleeding is stained with dark or scarlet blood, when bleeding from dilated veins of the rectum with hemorrhoids or from a crack in the anus, unchanged blood will be mixed with scarlet feces. The main causes of gastrointestinal bleeding are as follows. • Peptic ulcer of the stomach and duodenum; • Rupture of the gastric and esophageal mucosa after heavy vomiting; • Infectious diseases (dysentery, typhoid fever, etc.); • Mesenteric vascular thrombosis; • Varicose veins of the esophagus and the cardiac part of the stomach in portal hypertension, submucosal layer of the end part of the rectum in hemorrhoids; • Blood diseases-leukemia, hemorrhagic diathesis; • Disintegration of intestinal tumors; • Intestinal diverticulosis; • Inflammatory bowel diseases (ulcerative colitis, Crohn’s disease); A late symptom is collapse and laboratory-registered anemia. You can identify the cause at stage 1 in 40–50% of cases. The main task is to identify the fact of acute hemorrhage, conduct emergency measures and hospitalization. The nurse must prepare the equipment and tools: a system for intravenous in- fusions, syringes, tourniquet; everything necessary to determine the blood group and RH factor. Independent assistance: 1. immediately call a doctor through the 3rd person. 2. Provide rest in a horizontal position. Soothe and put turn the patient’s head to one side. 3. Measure your blood pressure, count your pulse, and if your blood pressure drops, lift the foot end of the bed 4. Put an ice pack on the epigastric area.