First Year Fellows Endoscopy Course (July 28-29)

1_Intro to Endoscopy

Pdf Summary

The ASGE First Year Fellows' Endoscopy Course provides an introduction to endoscopy, covering topics such as informed consent, patient preparation, antibiotics, anticoagulation, sedation, and complications.<br /><br />Informed consent is a critical part of the process, involving the disclosure of the procedure, its benefits, potential risks, alternatives, and potential harms of not proceeding. It is important to discuss worst possible outcomes, missed lesions, and use witnesses to ensure understanding and document the process.<br /><br />Patient preparation includes guidelines for oral intake, with specific timeframes for solid food and clear liquids, and emphasizes the consequences of inadequate cleansing, which hinder polyp detection and may increase complications.<br /><br />Antibiotic prophylaxis is recommended for specific procedures such as PEG or D-PEJ placement, ERCP with incomplete drainage, and EUS-FNA of mediastinal cysts or pancreatic cyst aspiration. However, administration of antibiotics solely to prevent endocarditis is not recommended.<br /><br />Regarding anticoagulation, there are guidelines for managing patients on warfarin, LMWH, and antiplatelet medications during endoscopic procedures, considering the bleeding risk and thromboembolic risk.<br /><br />Procedural sedation requires monitoring, including pulse oximetry, blood pressure, continuous lead monitoring, and knowing the location of resuscitation equipment. It is important to assess patient risk factors and medication requirements, perform an airway assessment, and decrease sedation doses for high-risk patients.<br /><br />Complications of sedation can include allergic reactions, local skin reactions, and arterial oxygen desaturation. Prevention, detection, and appropriate treatment are essential, and communication with patients, families, and other providers, as well as prompt assessment and management, are crucial.<br /><br />In summary, the course highlights the importance of informed consent, patient preparation, appropriate antibiotic prophylaxis, management of anticoagulation, and safe sedation practices in endoscopic procedures. Understanding and addressing potential complications is essential for providing optimal patient care.

Keywords

ASGE First Year Fellows' Endoscopy Course

endoscopy

informed consent

patient preparation

antibiotics

anticoagulation

sedation

complications

procedural sedation

endoscopic procedures