First Year Fellows Endoscopy Course (August 5 - 6)

1_Intro to Endoscopy

Pdf Summary

The document is a summary of key points from the ASGE First Year Fellows' Endoscopy Course on the Introduction to Endoscopy. <br /><br />The first section discusses informed consent, emphasizing the importance of disclosure and full communication with patients about the procedure, including its benefits, risks, and alternatives. It recommends discussing the worst possible outcomes and using layman's terms to ensure understanding. The guideline also suggests involving witnesses and documenting the process.<br /><br />Patient preparation is highlighted next, with guidelines on oral intake and NPO guidelines before the procedure. Emphasizing the importance of adequate cleansing, the document explains the consequences of inadequate cleansing and how it hinders polyp detection and may increase the risk and severity of complications.<br /><br />Antibiotic prophylaxis is discussed, stating that it is not recommended solely to prevent endocarditis for gastrointestinal procedures. However, there are specific situations where antibiotic prophylaxis is recommended, such as PEG or D-PEJ placement, ERCP with incomplete drainage, and EUS-FNA procedures.<br /><br />The document also addresses the management of antithrombotic agents during endoscopy, stating that discontinuation of aspirin or NSAIDs prior to the procedure is not supported by data. It provides guidelines for patients on warfarin, LMWH, and antiplatelet medications, based on the bleeding and thromboembolic risks of the procedure.<br /><br />Sedation and procedural monitoring are discussed, with tips for assessing patients before the procedure and ensuring appropriate monitoring and equipment. Complications of sedation are mentioned, including allergic reactions and arterial oxygen desaturation, with the need for prompt assessment and communication.<br /><br />The document emphasizes the general principles for preventing, detecting, and treating complications. It encourages proper patient assessment, not minimizing complications, and prompt communication with the patient, family, and other healthcare providers.<br /><br />In conclusion, the document emphasizes the importance of informed consent, patient preparation, appropriate antibiotic prophylaxis, and management of antithrombotic agents during endoscopy. It also highlights the importance of proper sedation procedures and general principles for preventing and managing complications.

Keywords

informed consent

patient preparation

adequate cleansing

antibiotic prophylaxis

management of antithrombotic agents

sedation

complications

patient assessment

communication

preventing complications