First Year Fellows Endoscopy Course (July 31 - August 1)

1_Intro to Endoscopy

Pdf Summary

The ASGE First Year Fellows' Endoscopy Course covers various topics related to endoscopy, including informed consent, patient preparation, antibiotics, anticoagulation, sedation, and complications. Informed consent is discussed as a process that involves disclosure of information to the patient, including the description of the procedure, its benefits, potential risks and adverse events, alternatives, and potential needs for intubation, resuscitation, hospitalization, and blood transfusion. It is important to discuss the "worst possible outcomes" with patients, such as ICU care, blood transfusions, surgery, and the remote possibility of death. Layman's terms should be used to explain the procedure and risks, and patients and their families should be encouraged to participate and ask questions.<br /><br />Patient preparation includes guidelines for oral intake before endoscopic procedures, with specific recommendations for minimum fasting times after consuming solid food or clear liquids. Inadequate cleansing can hinder polyp detection and may necessitate a repeat procedure. Antibiotic prophylaxis is not recommended solely for the prevention of endocarditis in patients undergoing gastrointestinal procedures, and it is not warranted for patients who receive antibiotics for dental procedures or those who request them without a clear reason. However, antibiotic prophylaxis is recommended for certain procedures like PEG or D-PEJ placement, ERCP with incomplete drainage, and EUS-FNA of mediastinal or pancreatic cysts.<br /><br />Regarding anticoagulation, there are guidelines for managing patients on anticoagulant or antiplatelet medications before endoscopic procedures based on bleeding risk and thromboembolic risk. Sedation during endoscopic procedures requires close monitoring and assessment of patients beforehand, including considerations for patient risk factors and medication requirements. Complications of sedation can include local and systemic allergic reactions, local skin reactions, and arterial oxygen desaturation.<br /><br />Overall, it is important for healthcare providers to engage in informed consent, proper patient preparation, appropriate use of antibiotics and anticoagulation management, and vigilant monitoring and management of complications during endoscopic procedures.

Keywords

ASGE First Year Fellows' Endoscopy Course

informed consent

patient preparation

antibiotics

anticoagulation

sedation

complications

oral intake guidelines

antibiotic prophylaxis

anticoagulation management