scholarly journals Development and evaluation of a novel protective device for upper gastrointestinal endoscopy in the COVID-19 pandemic: the EBOX

2020 ◽  
pp. flgastro-2020-101542 ◽  
Author(s):  
Robert William John Mcleod ◽  
Neil Warren ◽  
Stuart Ashley Roberts
Keyword(s):  
Healthcare Workers ◽  
Clinical Utility ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Endoscopic Retrograde ◽  
Team Members ◽  
Valuable Adjunct ◽  
Standard Manner ◽  
The Impact ◽  
Upper Gastrointestinal

BackgroundDuring the COVID-19 pandemic, aerosol-generating procedures such as upper gastrointestinal endoscopy (UGIE) have been considered high risk. We designed a novel acrylic box (endoscopy box (EBOX)) with the intention of limiting aerosol and droplet spread during such procedures. We evaluated clinical utility, impact on the endoscopy team and also assessed the impact of the EBOX on macroscopic droplet spread from a simulated cough during UGIE.MethodsClinical utility was evaluated prospectively via EBOX use on 15 patients undergoing endoscopic retrograde cholangiopancreatography (13) or endoscopic ultrasound (2). Feedback was recorded from the endoscopy team regarding ease of positioning, impact of the EBOX on procedural performance and cleaning. A cough was simulated via explosion of a hyperinflated balloon containing 0.75 mL of ultraviolet disclosing lotion within the oral cavity of a mannequin, with and without the EBOX. Macroscopic spread was then evaluated with a ultraviolet torch.ResultsThree endoscopists and the team members found that the EBOX did not hamper the procedure and felt it was a useful adjunct to full personal protective equipment (PPE). Simulated cough without the EBOX identified macroscopic spread up to 2.3 m away from the patient’s mouth as well as onto key areas such as the exposed neck of the endoscopist, which is not considered in current PPE guidance. Simulated cough using the EBOX significantly reduced macroscopic spread onto key areas of the healthcare workers.ConclusionsThe EBOX is a valuable adjunct to recommended PPE for UGIE, but still allows these procedures to be performed in the standard manner.

2451 THE IMPACT OF SEDATION VERSUS NO SEDATION IN THE PERFORMANCE OF UPPER GASTROINTESTINAL ENDOSCOPY.

2000 ◽  
Vol 51 (4) ◽  
pp. AB59 ◽  
Author(s):  
Neena S. Abraham ◽  
Jack Huang ◽  
Paul Wieczorek ◽  
Serge Mayrand ◽  
Alan N. Barkun
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
The Impact ◽  
Upper Gastrointestinal

scholarly journals The impact of gastroesophageal reflux in the ENT pathology

2016 ◽  
Vol 6 (23) ◽  
pp. 141-148
Author(s):  
Violeta Melinte ◽  
Codrut Sarafoleanu
Keyword(s):  
Gastroesophageal Reflux ◽  
Chronic Condition ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Medical Risk ◽  
Inflammatory Conditions ◽  
Medical Risk Factors ◽  
Gastric Contents ◽  
The Impact ◽  
Upper Gastrointestinal

Abstract Frequently encountered in medical practice, the gastroesophageal reflux (GER) is a chronic condition characterized by the passage of gastric acid or gastric contents into the esophagus. In otorhinolaryngology, the diagnosis of pharyngo-laryngeal or rhinosinusal inflammatory conditions secondary to GER is one of exclusion and it is based on a detailed anamnesis in which we are interested in symptoms, behavioural and medical risk factors, on the ENT clinical examination, the laryngo-fibroscopical assessment, the phoniatric examination, the barite pharyngo-esogastric exam, the upper gastrointestinal endoscopy and the esophageal manometry. The authors are making a systematization of the contribution of the gastroesophageal reflux has in the ENT pathology, emphasising the sympytoms and the most frequent associated pathological entities.

scholarly journals Novel mainstream capnometer system is safe and feasible even under CO2 insufflation during ERCP-related procedure: a pilot study

2019 ◽  
Vol 6 (1) ◽  
pp. e000266 ◽  
Author(s):  
Yoichi Takimoto ◽  
Eisuke Iwasaki ◽  
Tatsuhiro Masaoka ◽  
Seiichiro Fukuhara ◽  
Shintaro Kawasaki ◽  
...  
Keyword(s):  
Adverse Event ◽  
Pilot Study ◽  
Gastrointestinal Endoscopy ◽  
Conscious Sedation ◽  
Upper Gastrointestinal Endoscopy ◽  
Intravenous Sedation ◽  
Endoscopic Retrograde ◽  
Bite Block ◽  
End Tidal ◽  
Upper Gastrointestinal

Background and aimsThere is a need to safely achieve conscious sedation during endoscopic retrograde cholangiopancreatography (ERCP). We evaluated the safety and feasibility of a mainstream capnometer system to monitor apnoea during ERCP under CO2 insufflation.MethodsNon-intubated adult patients undergoing ERCP-related procedures with intravenous sedation were enrolled. End-tidal CO2 (EtCO2) was continuously monitored during the procedure under CO2 insufflation using a mainstream capnometer system, comprising a capnometer and a specially designed bite block for upper gastrointestinal endoscopy and ERCP. Oxygen saturation (SpO2) was also monitored continuously during the procedure. In this study, we evaluated the safety and feasibility of the capnometer system.ResultsEleven patients were enrolled. Measurement of EtCO2 concentration was possible from the beginning to the end of the procedure in all 11 cases. There was no measurement failure, dislocation of the bite block, or adverse event related to the bite block. Apnoea linked to hypoxaemia occurred five times (mean duration, 174.4 s).ConclusionThis study confirmed that apnoea was detected earlier than when using a percutaneous oxygen monitor. Measurement of EtCO2 concentration using the newly developed mainstream capnometer system was feasible and safe even under CO2 insufflation.

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