First Year Fellows Endoscopy Course ( August 6-7)

1_Intro to Endoscopy

Pdf Summary

The ASGE First Year Fellows' Endoscopy Course covers several important topics related to endoscopy. The course begins with a discussion on informed consent, emphasizing the importance of fully explaining the procedure, its benefits, potential risks, and alternatives to the patient. It is also important to discuss potential needs for intubation, resuscitation, hospitalization, and blood transfusion. Full disclosure strengthens the physician-patient relationship.<br /><br />In terms of patient preparation, the course highlights the importance of following NPO guidelines, which typically involve fasting for a certain number of hours before the procedure. Inadequate cleansing of the GI tract can hinder polyp detection and may require the procedure to be repeated, potentially increasing the risk and severity of complications.<br /><br />The course addresses the use of antibiotics as prophylaxis for GI procedures. It is recommended to administer antibiotics for specific procedures such as PEG or D-PEJ placement, ERCP with incomplete drainage, EUS-FNA of mediastinal cysts, EUS-FNA for pancreatic cyst aspiration, and cirrhosis with acute GI bleeding. However, administration of antibiotics solely to prevent endocarditis or in response to a patient's request without a valid reason is not recommended.<br /><br />The management of antithrombotic agents, such as antiplatelet medications, before GI procedures is also discussed. Generally, there is no need to discontinue aspirin or NSAIDs, but there may be a need to consider discontinuing Plavix (clopidogrel) for high-risk procedures.<br /><br />Procedural sedation is another important topic covered in the course. It emphasizes the need for careful assessment of patients before the procedure, taking into account risk factors, medication requirements, and airway assessment. Procedural monitoring, including pulse oximetry, blood pressure, and continuous lead monitoring, is essential. Complications of sedation, such as allergic reactions and arterial oxygen desaturation, are discussed, along with prevention, detection, and treatment strategies.<br /><br />The course concludes with a reminder to maintain a high level of suspicion for complications, promptly communicate with patients and other providers, and not to minimize complications. In summary, the ASGE First Year Fellows' Endoscopy Course covers important aspects of endoscopy, including informed consent, patient preparation, antibiotics, anticoagulation, sedation, and complications.

Keywords

ASGE First Year Fellows' Endoscopy Course

informed consent

patient preparation

NPO guidelines

GI tract cleansing

antibiotics as prophylaxis

antithrombotic agents

procedural sedation

complications of sedation

communication with patients and providers