First aid for massive hematemesis with high prothrombin time begins with maintaining a patent airway, fluid replacement and volume expansion, monitoring vital signs, hemostasis, and treating the cause. Specific summarized as follows: 1. Keep the airway open first A large amount of vomiting blood is very easy to happen misaspiration, blood clot obstruction of the airway and other situations, leading to the airway is not open situation, or even suffocation, life-threatening. It is necessary to keep the patient’s head tilted to one side to prevent asphyxiation, and clean the blood clots in the mouth and airway in time. 2. Replenish fluids and expand blood volume Large amount of blood loss will lead to insufficient blood volume, even hemorrhagic shock, need to replenish fluids in time to expand the volume, can replenish plasma and so on. 3.Monitoring vital signs Closely monitor the vital signs, and in case of respiratory arrest, cardiopulmonary resuscitation (CPR) should be performed immediately. According to the vital signs, adjust the treatment program. 4. Stop bleeding Stop bleeding if there is a lot of vomiting, use thrombin and other hemostatic drugs, and intervene to stop bleeding if necessary. 5. Treatment for the cause of disease Actively search for the cause of the disease, to define whether it is hemoptysis or vomiting, to define whether it is caused by respiratory diseases or digestive diseases, to define the cause of the disease, to define the cause of the prolongation of the prothrombin time needs to be defined, whether it is due to the patient’s oral anticoagulant drugs, such as warfarin, or the abnormal function of the liver or hematological system diseases, to address the cause of the disease, for example, fundal varices of the esophagus, which need to be targeted at the treatment of cirrhosis, to take surgery or portal shunt. Surgery or portal vein shunt is performed, and the dose of anticoagulant drugs is adjusted. In conclusion, if there is a large amount of bleeding with high thromboplastin, it must be sent to the emergency department of the hospital in a timely manner.