First Year Fellows Endoscopy Course (July 29 - 30)

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. Informed consent is a crucial process that includes providing patients with information about the procedure, its benefits, potential risks and adverse events, alternatives, and potential needs for further medical intervention. It is important to discuss the worst possible outcomes, such as ICU care, blood transfusions, surgery, and even the remote possibility of death. Layman's terms should be used and the participation of the patient, their family, and significant others should be encouraged. The risks associated with endoscopic procedures differ, with EGD having an adverse event rate of 1:200-1:10,000, colonoscopy 2.8:100, EGD with dilation 1:100, PEG 5:100, and ERCP with pancreatitis occurring in about 1:20-30 cases. Patient preparation includes guidelines for oral intake, emphasizing the consequences of inadequate cleansing, such as hindering polyp detection and increasing procedure time. Antibiotic prophylaxis is generally not recommended for endoscopic procedures, except in certain cases 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. The management of antithrombotic agents for patients undergoing endoscopy depends on the bleeding and thromboembolic risk of the procedure, with adjustments in anticoagulation and antiplatelet medications. Procedural sedation requires careful assessment of patient risk factors and medication requirements, as well as the use of appropriate monitoring and equipment. Complications can occur, but prevention, detection, and prompt treatment are key. Overall, communication, thorough documentation, and avoiding the minimization of complications are crucial in ensuring a successful endoscopic procedure.

Keywords

ASGE First Year Fellows' Endoscopy Course

endoscopy introduction

informed consent

patient preparation

antibiotics

anticoagulation

sedation

complications

endoscopic procedure risks

patient participation