First Year Fellows Endoscopy Course (Aug 1-2)

1_Intro to Endoscopy
Pdf Summary
The ASGE First Year Fellows' Endoscopy Course provides an introduction to various aspects of endoscopy. The course covers topics such as informed consent, patient preparation, antibiotics, anticoagulation, sedation, and complications.<br /><br />Informed consent is a process that involves disclosing information about the procedure, including its nature, benefits, risks, alternatives, and limitations. It is important to use layman's terms and encourage the participation of both the patient and their family. The possible risks of the procedure should be explained, and worst-case scenarios should be discussed. It is also important to use witnesses and document the entire process.<br /><br />For patient preparation, oral intake should be restricted to essential medications, and patients should be instructed to have nothing by mouth for a certain period of time before the procedure. Inadequate cleansing can hinder polyp detection and may require the procedure to be repeated.<br /><br />Antibiotic prophylaxis is not recommended for all patients undergoing gastrointestinal procedures, but it may be necessary for certain high-risk procedures. Bacteremia rates vary depending on the type of endoscopic procedure, and antibiotic prophylaxis may be recommended for procedures such as PEG, ERCP with incomplete drainage, and EUS-FNA for cyst aspiration.<br /><br />There is no data supporting the discontinuation of aspirin or NSAIDs prior to endoscopic procedures, but discontinuation of Plavix should be considered for high-risk procedures. Anticoagulation management for low-risk and high-risk procedures varies, and adjustments should be made based on the reason for which the patient is being anticoagulated.<br /><br />Procedural sedation requires careful monitoring, and it is important to assess the patient before the procedure and adjust medication doses based on patient characteristics. Complications of sedation may include allergic reactions, skin reactions, and arterial oxygen desaturation.<br /><br />General principles for managing complications include prevention, detection, and treatment. It is important to be diligent in patient preparation, not to minimize complications, and to communicate openly and promptly with the patient, family, and other providers.<br /><br />In conclusion, the ASGE First Year Fellows' Endoscopy Course covers various important aspects of endoscopy, including informed consent, patient preparation, antibiotics, anticoagulation, sedation, and complications. It emphasizes the importance of patient education, diligent preparation, and careful management of complications.
Keywords
ASGE First Year Fellows' Endoscopy Course
endoscopy
informed consent
patient preparation
antibiotics
anticoagulation
sedation
complications
procedural sedation
complication management