First Year Fellows Endoscopy Course (Aug 6-7)

1_Intro to Endoscopy
Pdf Summary
The ASGE First Year Fellows’ Endoscopy Course covers a range of topics related to endoscopy, including informed consent, patient preparation, antibiotics, anticoagulation, sedation, and complications. The course emphasizes the importance of full disclosure in the informed consent process, using layman’s terms and encouraging patient participation. Risks and possible complications of the procedures should be explained, including the chance of ICU care, blood transfusions, surgery, and the remote possibility of death. The course also emphasizes the importance of discussing missed lesions and using witnesses during the informed consent process.<br /><br />Patient preparation includes guidelines for oral intake before the procedure, such as NPO solids for 6 hours and clear liquids for 2 hours, with longer fasting times for patients with gastroparesis. Inadequate cleansing is emphasized as a hindrance to polyp detection and may require repeating the procedure.<br /><br />Antibiotic prophylaxis is not recommended solely to prevent endocarditis for patients undergoing gastrointestinal procedures. The course provides rates of bacteremia for various endoscopic procedures and daily activities to aid in decision-making for antibiotic prophylaxis. However, specific recommendations for antibiotic prophylaxis are suggested for certain procedures, such as PEG, ERCP with incomplete drainage, and ERCP in the presence of pancreatic pseudocyst.<br /><br />Management of anticoagulants is discussed for both low-risk and high-risk procedures. For low-risk procedures, there is no need to change anticoagulation, while high-risk procedures and low-risk conditions may require stopping anticoagulation a few days before the procedure. High-risk procedures and high-risk conditions may require bridging with heparin or LMWH.<br /><br />General principles for sedation during GI procedures include assessing the patient beforehand, adjusting the dose for specific patient characteristics, and being prepared with monitoring and equipment. Complications related to sedation, such as allergic reactions and oxygen desaturation, should be monitored and addressed promptly.<br /><br />Overall, the ASGE First Year Fellows’ Endoscopy Course emphasizes the importance of informed consent, patient preparation, following guidelines for antibiotics and anticoagulants, and being vigilant about potential complications during endoscopic procedures.
Keywords
ASGE First Year Fellows' Endoscopy Course
informed consent
patient preparation
antibiotics
anticoagulation
sedation
complications
oral intake
antibiotic prophylaxis
sedation principles