Masterclass: EndoQuest - Endoscopy in the GI Unit (On-demand) | September 2025-Emergency Readiness: Endoscopy Tools and Procedures for GI Nurses and Technicians

Video Transcription

Video Summary

In this comprehensive talk, Dr. Tal discusses emergency endoscopy call procedures, focusing primarily on effective hemostasis techniques and secondarily on foreign body retrieval. He emphasizes the importance of preparing the field by clearing large blood clots obstructing visualization, augmenting suction flow using therapeutic scopes and adapting tubing length, and patient positioning to facilitate clot movement. The talk details the four main hemostatic tool categories: thermal (monopolar and bipolar forceps, APC), mechanical (clips), topical agents (powders, gels), and injection therapy. Thermal devices like hot biopsy and coagulation forceps combine mechanical closure and cauterization for precise vessel sealing, particularly useful for bleeding "vessels on a ridge." Bipolar probes offer targeted cauterization with less tissue injury, while argon plasma coagulation (APC) provides superficial, non-contact coagulation ideal for vascular ectasias. Mechanical clips, both through-the-scope and over-the-scope, vary in design and usability, with over-the-scope clips serving as powerful rescue options but requiring careful deployment. Topical hemostatic powders, such as Hemo Spray, are valuable rescue tools in torrential bleeding. On foreign body retrieval, Dr. Tal highlights the use of clear caps, retrieval nets, rotatable grasping forceps combining alligator and rat tooth jaws, and over-tubes (rigid and rigidizing) to protect mucosa and facilitate multiple passes. Proper device selection, preparation, and closed-loop communication with physicians are emphasized throughout for efficient, safe emergency endoscopy management.

Asset Subtitle

Dr. Andy Tau

Keywords

emergency endoscopy

hemostasis techniques

foreign body retrieval

thermal hemostatic devices

mechanical clips

topical hemostatic agents

injection therapy

endoscopic suction optimization

patient positioning