ASGE Annual GI Advanced Practice Provider Course (Virtual) (Day One)

Video Transcription

Video Summary

The panel conducts a Q&A on endoscopy preparation and risk management. For SIADH patients, they prefer an isosmotic 4-liter PEG prep to minimize fluid shifts, and emphasize coordinating with the managing clinician (internist/endocrinologist) and following guidelines. They stress reassessing whether high-risk patients truly need the procedure. For ischemic colitis, colonoscopy is usually unnecessary for diagnosis; if needed, a limited flex sig may suffice, while full colonoscopy is reserved for special concerns (e.g., tissue viability). Low BMI alone doesn’t mandate MAC, but very low sedation dosing limits may. For high-risk cardiac patients, they often refer to pre-anesthesia testing and use institutional checklists (e.g., very low EF, unstable angina, recent MI). For elderly patients, they avoid low-volume/electrolyte-shifting preps, often using 4-liter PEG with added support.

Keywords

Endoscopy preparation

SIADH bowel prep 4-liter PEG

Ischemic colitis colonoscopy vs flexible sigmoidoscopy

High-risk cardiac patient pre-anesthesia testing

Elderly patient bowel prep risk management