First Year Fellows Endoscopy Course (August 7 - 8)

10_The On Call Call

Pdf Summary

The text discusses various scenarios and considerations when dealing with on-call responsibilities as a gastrointestinal (GI) fellow. In the first case, a patient calls with a question about their colonoscopy preparation. The principles of great customer service, including speed, accuracy, transparency, accessibility, and patient-centeredness, are highlighted. The types of colonoscopy preparations and diet instructions are outlined, with an emphasis on knowing the specific practices of one's institution. The management of medications, particularly for diabetic patients, is also discussed.<br /><br />In the second case, an ICU resident calls about a patient with GI bleeding. The difference between emergent and urgent endoscopy is explained, along with indications for each. The importance of assessing the patient's condition and communicating with the appropriate healthcare professionals is emphasized.<br /><br />In the third case, a patient calls with post-colonoscopy pain. The differential diagnosis for post-procedure pain is presented, including perforation and post-polypectomy syndrome. The appropriate steps, such as sending the patient to the emergency room and obtaining a CT scan, are outlined.<br /><br />The text concludes with a brief mention of post-ERCP complications, including pancreatitis, post-sphincterotomy bleeding, and perforation. General principles, such as assuming a complication until proven otherwise and early communication with attending physicians and other specialties, are highlighted.

Keywords

on-call responsibilities

colonoscopy preparation

customer service

diet instructions

medication management

GI bleeding

endoscopy

post-procedure pain

perforation

ERCP complications