In the setting of a balloon tamponade for variceal bleeding, which precaution is essential to ensure patient safety?

• A. Administer diuretics
• B. Monitor airway patency
• C. Avoid oxygen
• D. Increase IV fluids

Answer: (B)

Airway protection is the key safety precaution with balloon tamponade for variceal bleeding. The esophageal and gastric balloons can interfere with the airway, and blood and secretions from the bleed can be aspirated if the airway isn’t secure. So, ensure the patient’s airway remains patent by positioning the head of the bed appropriately, having suction ready, and being prepared to advance to endotracheal intubation if respiratory status worsens. Continuous monitoring of oxygenation and ventilation is essential while the balloon stays in place, since this device is a temporizing measure and maintaining a clear airway is critical for patient safety.