ASGE Adult and Pediatric Gastroenterology and Endoscopy Board Preparatory and Review Course | 2022-Glessing_Breakout: Patient prep, monitoring and sedation

Glessing_Breakout: Patient prep, monitoring and sedation

Pdf Summary

This document is a summary of a presentation on patient preparation, monitoring, and sedation for a gastroenterology and endoscopy board review course. The presentation discusses various cases and provides quick fire round questions with multiple choice answers.<br /><br />In the first case, a 62-year-old male with a history of prostate cancer, mitral valve replacement, anticoagulation, and an implanted cardioverter-defibrillator (ICD)/pacemaker is referred for a colonoscopy. The patient is considering using an over-the-counter bowel preparation (MiraLAX). The presentation explains that while this preparation is popular and well-tolerated, it is not FDA-approved and has not been associated with electrolyte imbalances.<br /><br />The second case involves managing anti-thrombotic therapy in a patient undergoing endoscopy. The appropriate pre-procedure advice regarding anti-thrombotics for a patient taking warfarin and aspirin is to stop warfarin 5 days prior to the procedure and continue aspirin.<br /><br />The presentation also addresses the management of pacemakers during endoscopic procedures. In a patient who is pacemaker dependent, it is recommended to consider pacemaker reprogramming prior to the procedure. The pacemaker should be placed in an asynchronous mode throughout the entire procedure.<br /><br />Other topics covered include the most appropriate management for polyps identified during a colonoscopy in a patient on warfarin (resect the polyps using the cold snare technique), and the potential risk of dysfunction of an ICD during different endoscopic procedures (all options mentioned pose a potential risk).<br /><br />The presentation includes references to guidelines and studies supporting the recommendations. It also provides information on additional resources that may be beneficial for further learning. The conclusion of the presentation describes a successful colonoscopy with polyp removal in the patient from the first case. The patient will follow up for further evaluation of his anemia.

Keywords

patient preparation

monitoring

sedation

gastroenterology

endoscopy

board review course

colonoscopy

bowel preparation

anti-thrombotic therapy

pacemakers