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

Pdf Summary

Upper GI endoscopy, also known as EGD, is a procedure used to examine the upper gastrointestinal tract. It includes several procedures such as esophagoscopy, esophagogastroscopy, push enteroscopy, and balloon enteroscopy. The procedure can be performed through the mouth or the nares. It is indicated for various reasons such as the evaluation of gastroesophageal reflux, dysphagia, upper abdominal discomfort, gastrointestinal bleeding, and surveillance of conditions like Barrett's esophagus.<br /><br />Before performing the procedure, the informed consent process should include a discussion about the indication for the procedure, procedure-related risks, and an opportunity for the patient to ask questions. Proper preparation for the procedure is necessary, including fasting, managing medications like antithrombotics and antibiotics, and ensuring appropriate glycemic control. Adverse events related to sedation/anesthesia, intra-procedure complications, and delayed complications should be considered. Patients should be provided with post-procedure instructions, including follow-up appointments, dietary restrictions, and medication management.<br /><br />During the procedure, the endoscopist should communicate with the patient, explain the procedure, and address any concerns or fears. Informed consent involves discussing the indication, risks, potential benefits, alternatives, and addressing patient questions. The procedure may reveal conditions such as esophagitis, esophageal varices, ulcers, and gastrointestinal bleeding sources.<br /><br />The overall adverse event rate for upper GI endoscopy is low, with rare major complications. Cardiopulmonary complications and perforation are some potential risks. Antibiotic prophylaxis is recommended for cirrhotic patients with active gastrointestinal bleeding and PEG tube placements but generally not for other EGDs.<br /><br />After the procedure, the patient should be visited to assess recovery, review findings, and provide follow-up instructions. Adverse events, delayed complications, and medication instructions should be discussed. Informed consent is an ongoing process and is essential for proper patient care. Quality metrics and best practices should be observed throughout the procedure and post-procedure care.<br /><br />In summary, upper GI endoscopy is a procedure used to evaluate and treat various conditions affecting the upper gastrointestinal tract. It is important to ensure appropriate indications, obtain informed consent, and follow proper pre-procedure and post-procedure care protocols to ensure patient safety and optimal outcomes.

Asset Subtitle

John Martin, MD, FASGE

Keywords

Upper GI endoscopy

EGD

upper gastrointestinal tract

gastroesophageal reflux

dysphagia

gastrointestinal bleeding

Barrett's esophagus

informed consent

sedation/anesthesia

post-procedure care