A 58-year-old man with a history of NSAID use for chronic back pain presents to the emergency department with sudden onset hematemesis and melena. His blood pressure is 90/60 mmHg, heart rate 110 bpm, and he appears pale and diaphoretic. Initial labs show hemoglobin of 7.2 g/dL. After establishing two large-bore intravenous lines and initiating fluid resuscitation, what is the most appropriate next diagnostic and therapeutic step?
✓ Correct Answer: Option C
Hemodynamically unstable patients with suspected upper GI bleeding require urgent management. After fluid resuscitation, a proton pump inhibitor infusion should be started, and an urgent upper endoscopy is the definitive diagnostic and therapeutic procedure to identify and treat the bleeding source.