ASGE Annual GI Advanced Practice Provider Course - Day Two (On-Demand)

15_Upper Endoscopy-Kaul

Pdf Summary

In this lecture on upper endoscopy basics, Dr. Vivek Kaul discusses various aspects of the procedure. He emphasizes the importance of appropriate patient selection and timing of the procedure. With 6.1 million EGDs performed annually in the US at an estimated cost of $12.3 billion, it is crucial to ensure the procedure is indicated and performed correctly. Dr. Kaul also highlights the key considerations for EGD, including patient preparation, sedation requirements, and informed consent.<br /><br />Informed consent is crucial as it provides legal protection and ensures effective communication with patients. Dr. Kaul discusses the elements of informed consent, including the nature and reason for the procedure, risks and benefits, and alternatives. He also addresses special considerations for pediatric consent, emphasizing the importance of obtaining assent from adolescents.<br /><br />Upper endoscopy serves as a portal for various procedures, such as EUS, DBE, ERCP, and more. Indications for diagnostic upper endoscopy include dysphagia, GI bleeding, and reflux refractory to medical therapy. Dr. Kaul also discusses screening and surveillance EGD for conditions like Barrett's esophagus and UGI malignancies.<br /><br />Some common findings during EGD include esophagitis, upper GI bleeding causes, and Barrett's esophagus. Dr. Kaul also covers therapeutic EGD, which involves procedures like hemostasis, endoscopic resection, and stent placement. He presents videos demonstrating endoscopic ablation techniques, esophageal stenting, and EUS-FNA of pancreatic mass.<br /><br />Adverse events associated with EGDs include cardiopulmonary events, infection, perforation, bleeding, and aspiration. Dr. Kaul emphasizes the importance of antibiotic prophylaxis in specific cases and provides pre and post-procedure quality indicators. Discharge instructions should include any significant findings, follow-up instructions, and contact information.<br /><br />In conclusion, Dr. Kaul highlights the importance of appropriate indications, informed consent, and careful consideration of risks vs. benefits for EGD procedures. Following quality metrics and practicing good communication with patients are essential. A polling question section tests the participants' knowledge on topics such as antibiotic prophylaxis and adverse events associated with EGD.

Keywords

upper endoscopy basics

patient selection

procedure timing

informed consent

diagnostic upper endoscopy

screening and surveillance EGD

therapeutic EGD

adverse events associated with EGD

antibiotic prophylaxis

communication with patients