ASGE Annual GI Advanced Practice Provider Course (On-Demand) - Onboarding (Day One) | March 2023-Informed Consent Sedation and Bowel Prep

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This document discusses informed consent, sedation, and bowel preparation for endoscopic procedures. Informed consent is a process that involves disclosure of the nature of the procedure, its benefits, risks, alternatives, and limitations. Layman's terms should be used to explain these elements, and a medical translator may be needed for effective communication. It is important to encourage patient participation and understanding through asking questions and providing clear explanations.<br /><br />Sedation is used to relieve patient anxiety and discomfort during procedures. The level of sedation can range from minimal to deep sedation or general anesthesia. NPO status guidelines help minimize the risk of aspiration, and essential medications can still be taken with small sips of water. Preprocedural assessment includes evaluating the patient's medical history, medications, and risk factors for adverse reactions to sedation.<br /><br />Complications of sedation can include allergic reactions, oxygen desaturation, and cardiopulmonary complications. Different levels of sedation require different medications, such as benzodiazepines for anxiety and opioids for pain. Anesthesia provider-administered deep sedation is an option for certain patients, but it may come with additional costs and potential risks.<br /><br />Bowel preparation for colonoscopy is crucial for effective visualization. Split dosing with polyethylene glycol is the preferred regimen, with the first dose given the day before the procedure and the second dose 3 to 8 hours prior. Various agents, including isosmotic, hyposmotic, hyperosmotic, and combination agents, can be used for bowel cleansing. Adjunctive measures, such as clear liquids and diet modifications, can also aid in preparation.<br /><br />Overall, this document emphasizes the importance of informed consent, proper sedation management, and effective bowel preparation for successful endoscopic procedures.

Asset Subtitle

John Martin, MD, FASGE

Keywords

informed consent

sedation

bowel preparation

endoscopic procedures

anxiety

complications

colonoscopy

visualization

regimen

patient participation