Problems With Combining Together EGD, PEG, Flexible Sigmoidoscopy, and Colonoscopy to Analyze Risks of Endoscopic Procedures After MI: A Call for Stratifying Risk According to Individual Endoscopic Procedures

2009 ◽  
Vol 43 (1) ◽  
pp. 98-99 ◽  
Author(s):  
Mitchell S. Cappell
Keyword(s):  
Flexible Sigmoidoscopy ◽  
Endoscopic Procedures

scholarly journals A148 EFFICIENCY IN THE ENDOSCOPY UNIT: CAN WE ‘TURN AROUND’ ROOM TURNOVER?

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 11-12
Author(s):  
C M Tan ◽  
J Tinmouth ◽  
M Bernstein
Keyword(s):  
Flexible Sigmoidoscopy ◽  
Turnover Time ◽  
Inclusion Criteria ◽  
Endoscopic Procedures ◽  
Improve Efficiency ◽  
Endoscopy Unit ◽  
Important Variation ◽  
Funding Agencies ◽  
Standard Operating ◽  
And Training

Abstract Background Endoscopy units across Canada are being challenged to meet the growing demand for procedures despite limited resources, highlighting the need to optimize endoscopy unit efficiency. Earlier studies have found that non-procedural factors, such as room turnover, represent an ideal target to improve efficiency. Aims The objective of this research project was to identify practices that will improve efficiency for routine outpatient gastrointestinal (GI) procedures at Sunnybrook Health Sciences Centre (SHSC). There were 2 sub-aims: 1) to understand practices at Toronto hospitals that shorten room turnover time and 2) to describe the variation in room turnover time at SHSC. Methods Sub-aim #1: A survey of endoscopy units at five other Toronto hospitals was completed. Questions were designed to gain a better understanding of routine practices and any initiatives undertaken to improve room turnover efficiency. Sub-aim #2: Median room turnover time from April 2018 to March 2019, defined as ‘patient out’ to ‘patient in’, was reported in an anonymized fashion for the following categories: 1) by endoscopist, 2) by nurse, and 3) by unique endoscopist-nurse pair. Only data from routine outpatient endoscopic procedures (e.g. colonoscopy, gastroscopy, flexible sigmoidoscopy) were included. In order to evaluate turnover times by endoscopist-nurse pair, consecutive cases not performed by the same pair were excluded. Procedures affected by patient- and transportation-related delays were also excluded. Results Of the five centers surveyed, three allocated 5 minutes for turnover and two allocated 10 minutes. All centers reported tracking turnover time and four centers reported undertaking initiatives to decrease turnover time such as involving a flow team, hiring team attendants, and sharing performance data. Over the 12-month period, 2504 routine outpatient GI endoscopic procedures were performed at SHSC, with 803 cases meeting inclusion criteria. Median turnover time for the unit was 6 minutes, ranging from 5 to 9 minutes across endoscopists, 5 to 7 minutes across nurses, and 3 to 10 minutes across unique endoscopist-nurse pairs (Figure 1). Efficiency of endoscopist-nurse pairs did not correlate with the number of cases performed as a pair over the 12-month period. Conclusions Endoscopy room turnover times at SHSC are similar to those reported by other local centers, with important variation across endoscopists and nurses. The next phase of this study will involve directly observing each of the most and least efficient individuals and pairs and recording common practices. It is anticipated that these findings will enable us to identify efficient practices that should be incorporated into standard operating procedures and training for endoscopy room personnel. Funding Agencies None

Respiratory Complications in Outpatient Endoscopy with Endoscopist-Directed Sedation

2014 ◽  
Vol 23 (3) ◽  
pp. 255-259 ◽  
Author(s):  
Kilian Friedrich ◽  
Sabine G. Scholl ◽  
Sebastian Beck ◽  
Daniel Gotthardt ◽  
Wolfgang Stremmel ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Respiratory Infection ◽  
Endoscopic Procedure ◽  
Shortness Of Breath ◽  
Respiratory Complications ◽  
Endoscopic Procedures ◽  
Increased Risk ◽  
High Incidence ◽  
Respiratory Complaints

Background & Aims: Respiratory complications represent an important adverse event of endoscopic procedures. We screened for respiratory complications after endoscopic procedures using a questionnaire and followed-up patients suggestive of respiratory infection.Method: In this prospective observational, multicenter study performed in Outpatient practices of gastroenterology we investigated 15,690 patients by questionnaires administered 24 hours after the endoscopic procedure.Results: 832 of the 15,690 patients stated at least one respiratory symptom after the endoscopic procedure: 829 patients reported coughing (5.28%), 23 fever (0.15%) and 116 shortness of breath (SOB, 0.74%); 130 of the 832 patients showed at least two concomitant respiratory symptoms (107 coughing + SOB, 17 coughing + fever, 6 coughing + coexisting fever + SOB) and 126 patients were followed-up to assess their respiratory complaints. Twenty-nine patients (follow-up: 22.31%, whole sample: 0.18%) reported signs of clinically evident respiratory infection and 15 patients (follow-up: 11.54%; whole sample: 0.1%) received therefore antibiotic treatment. Coughing or vomiting during the endoscopic procedure resulted in a 156.12-fold increased risk of respiratory complications (95% CI: 67.44 - 361.40) and 520.87-fold increased risk of requiring antibiotic treatment (95% CI: 178.01 - 1524.05). All patients of the follow-up sample who coughed or vomited during endoscopy developed clinically evident signs of respiratory infection and required antibiotic treatment while this occurred in a significantly lower proportion of patients without these symptoms (17.1% and 5.1%, respectively).Conclusions: We demonstrated that respiratory complications following endoscopic sedation are of comparably high incidence and we identified major predictors of aspiration pneumonia which could influence future surveillance strategies after endoscopic procedures.

Is the choice of anesthesia during gastrointestinal endoscopic procedures a result of anxiety?

2021 ◽  
Vol 22 (1) ◽  
pp. 56-60
Author(s):  
Harun Erdal ◽  
İbrahim Gündoğmuş ◽  
Mehmet Sinan Aydın ◽  
Bülent Çelik ◽  
Abdullah Bolu ◽  
...  
Keyword(s):  
Endoscopic Procedures

scholarly journals Crowned Dens Syndrome Occurring after Endoscopic Submucosal Dissection for Early Gastric Cancer

2021 ◽  
pp. 22-27
Author(s):  
Takeshi Okamoto ◽  
Takashi Ikeya ◽  
Katsuyuki Fukuda
Keyword(s):  
Gastric Cancer ◽  
Neck Pain ◽  
Endoscopic Submucosal Dissection ◽  
Odontoid Process ◽  
Calcium Pyrophosphate ◽  
Endoscopic Procedures ◽  
Submucosal Dissection ◽  
Calcium Pyrophosphate Dehydrate ◽  
Crowned Dens Syndrome ◽  
Head Computed Tomography

Crowned dens syndrome (CDS) is a rare form of pseudogout which causes acute neck pain due to calcium pyrophosphate dehydrate deposition surrounding the odontoid process, commonly causing neck pain with rigidity. While invasive procedures such as surgery are known to present a risk of acute pseudogout, reports of occurrence after endoscopic procedures are scarce. We report the case of a 75-year-old man who presented with sudden neck pain after endoscopic submucosal dissection (ESD) for gastric cancer. He could nod but could not rotate his head. Computed tomography showed calcifications surrounding the odontoid process consistent with CDS. Prolonged dietary restrictions and proton pump inhibitor use following the ESD procedure may have caused hypomagnesemia, a precipitating factor for CDS. We prescribed colchicine 1 mg/day and symptoms resolved completely in 3 days. This is the first report of CDS after ESD. CDS should be included in the differential diagnosis of neck pain after endoscopic procedures.

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