A 58-year-old male with a history of alcoholic cirrhosis presents to the emergency department with hematemesis and melena. His blood pressure is 85/50 mmHg, heart rate 115 bpm. He is pale and diaphoretic. Initial labs show hemoglobin of 7.2 g/dL. Which of the following is the most appropriate initial management step after securing airway and establishing large-bore IV access?

✓ Correct Answer: Option A

For acute variceal bleeding, immediate management includes hemodynamic stabilization, intravenous octreotide to reduce portal pressure, and broad-spectrum antibiotics to prevent infection. PPIs are often co-administered. Endoscopy and TIPS are definitive treatments that typically follow initial medical stabilization. Beta-blockers are for prophylaxis.