ASGE Annual GI Advanced Practice Provider Course (Virtual) (Day One) | March 2026-Pre-procedure Essentials: Informed Consent, Sedation, Bowel Preparation and Peri-procedural Medication Management

Pre-procedure Essentials: Informed Consent, Sedation, Bowel Preparation and Peri-procedural Medication Management

Video Transcription

Video Summary

The talk introduces endoscopy as a key tool in GI care and emphasizes that preparation can be as important as the procedure itself. It reviews four pre-procedure essentials: informed consent, sedation, bowel preparation, and periprocedural medication management.<br /><br />Informed consent is presented as an ongoing process—not just a signed form—and must cover the procedure’s indication, risks, benefits, alternatives, and limitations (including possible missed lesions). Patients should receive explanations in plain language, with interpreters when needed, and be given time to ask questions. Consent may be documented without a traditional signature if the patient cannot sign.<br /><br />Sedation is discussed across the full spectrum (none to general anesthesia). Goals include reducing pain and anxiety, improving safety and exam quality, and limiting unpleasant memories. Key elements include NPO status (typically 2 hours for clear liquids, 6 hours for solids), a focused pre-procedure assessment (airway, comorbidities, allergies, prior reactions), appropriate monitoring, and ensuring an escort home. Moderate sedation commonly uses midazolam plus fentanyl; deep sedation often uses propofol via anesthesia.<br /><br />Medication management highlights antithrombotics, limited indications for antibiotics, diabetes control, and GLP-1 considerations. For colonoscopy prep, split-dose 4L PEG is recommended for best cleansing and safety, tailored to patient risk (e.g., renal/cardiac disease).

Asset Subtitle

John A. Martin, MD, FASGE

Keywords

endoscopy

gastrointestinal care

informed consent process

sedation protocols

bowel preparation split-dose PEG

periprocedural medication management

antithrombotic and diabetes management