kidney, brain, or gangrene of arms or legs). An untreated patient could develop cerebral atrophy. Minimal blood loss
In cases that do not involve shock, treatment may involve proton pump inhibitors (such as omeprazole) to treat stomach ulcers if they are present. This is given until endoscopy can be arranged. Blood transfusions may be given if the level of hemoglobin in the blood is extremely low, that is less than 8.0 g/dL or 4.5–5.0 mmol/L. A patient may be kept nothing by mouth (or no eating or drinking). Adequate venous access (such as with large-bore cannulas or a central venous catheter) is generally obtained in case the patient develops a further bleed and becomes unstable. Significant blood loss
In a "hemodynamically significant" case of hematemesis, there may be shock. Resuscitation is an immediate priority to prevent death. Intravenous fluids and blood transfusions can be given, preferably by large bore intravenous cannula. The patient is prepared for emergency endoscopy, which is typically done in a operating theatre. Surgical opinion is usually sought in case the source of bleeding cannot be identified endoscopically, and laparotomy is necessary. Securing the airway is a top priority in hematemesis patients, especially those with a disturbed conscious level (hepatic encephalopathy in esophageal varices patient). This may be achieved with a cuffed endotracheal tube. Octreotide may be used if bleeding may be caused by varices. Techniques
Hematemesis, melena, and hematochezia are symptoms of acute gastrointestinal bleeding.
A single session of CBT in one of these modalities can be effective for individuals who have a specific phobia. Exposure therapy
Exposure therapy is a particularly effective form of CBT for many specific phobias, however, treatment acceptance and high drop-out rates have been noted as concerns. In addition, a third of people who complete exposure therapy as a treatment for specific phobia may not respond, regardless of the type of exposure therapy. Other interventions have been successful for particular types of specific phobia, such as virtual reality exposure therapy (VRET) for spider, dental, and height phobias, applied muscle tension (AMT) for needle phobia, and psychoeducation with relaxation exercises for fear of childbirth. With exposure therapy, a type of cognitive-behavioural therapy, clinically significant improvement was experienced by up to 90% of patients. While very long-term outcomes remain unknown, many of the benefits of exposure therapy persisted after one year. Treatment may be more successful at reducing symptoms in people with low trait anxiety, high motivation, and high self-efficacy entering exposure therapy. In addition, high cortisol levels, high heart rate variation, evoking disgust, avoiding relaxation, focusing on cognitive changes, context variation, sleep, and memory-enhancing drugs can also reduce symptoms following exposure therapy.Exposure can be "live"(in real life) or imaginal (in ones imagination) and can involve:

Systematic desensitization—A therapy that exposes the person to increasing levels of vivid stimuli gradually and frequently, while instructed to relax. Flooding—A therapy that exposes the person with a specific phobia to the most fearful stimulus first (i.e. the most intense part of the phobia).