Canadian Association of Gastroenterology Communique: After-Hours Endoscopy Cart.

After-hours endoscopy Therapeutic endoscopy Upper gastrointestinal bleed

Journal

Journal of the Canadian Association of Gastroenterology
ISSN: 2515-2092
Titre abrégé: J Can Assoc Gastroenterol
Pays: England
ID NLM: 101738684

Informations de publication

Date de publication:
Oct 2020
Historique:
received: 18 06 2019
accepted: 09 10 2019
entrez: 9 9 2020
pubmed: 10 9 2020
medline: 10 9 2020
Statut: ppublish

Résumé

Endoscopic procedures performed after-hours often require therapeutic interventions that are technically demanding for the endoscopist. The aim of this position paper is to provide guidance on the minimum standard of equipment that should be available on a mobile endoscopy cart for provision of a safe and effective after-hours emergency endoscopy service. The guidance is based on consensus among academic and community gastroenterologists in Canada. A modified Delphi process was used to establish consensus among 9 participants. A list of statements was prepared by an expert panel of endoscopists. The statements were divided into three broad sections for what should be on an after-hours endoscopy cart including medications, nonendoscopic tools and therapeutic/diagnostic equipment. Consensus for being on the endoscopy cart was achieved when 75% or more of voting members indicated 'agree'. For nonendoscopic tools, there was agreement for having sterile saline, sterile water, endoscope lubricant, various syringes, bite blocks (paediatric and adult size), a water pump with foot peddle, formalin jars for biopsy specimens, digital photo and printing capability and an overtube. For medications, there was agreement for having hyoscine butylbromide and epinephrine on the cart. For therapeutic/diagnostic tools, there was agreement for having biopsy forceps (standard and jumbo), polypectomy snares, sclerotherapy needles and agent (for a variceal bleed), band ligation kit, multipolar electrocautery probes, heater probe catheter, endoscopic clips, hemostatic powder and retrieval devices. This position paper provides guidance on the minimum standard of items that should be on an after-hours endoscopy cart. Standardization of equipment may help improve safety and quality of after-hours endoscopic procedures.

Sections du résumé

BACKGROUND BACKGROUND
Endoscopic procedures performed after-hours often require therapeutic interventions that are technically demanding for the endoscopist. The aim of this position paper is to provide guidance on the minimum standard of equipment that should be available on a mobile endoscopy cart for provision of a safe and effective after-hours emergency endoscopy service. The guidance is based on consensus among academic and community gastroenterologists in Canada.
METHODS METHODS
A modified Delphi process was used to establish consensus among 9 participants. A list of statements was prepared by an expert panel of endoscopists. The statements were divided into three broad sections for what should be on an after-hours endoscopy cart including medications, nonendoscopic tools and therapeutic/diagnostic equipment. Consensus for being on the endoscopy cart was achieved when 75% or more of voting members indicated 'agree'.
RESULTS RESULTS
For nonendoscopic tools, there was agreement for having sterile saline, sterile water, endoscope lubricant, various syringes, bite blocks (paediatric and adult size), a water pump with foot peddle, formalin jars for biopsy specimens, digital photo and printing capability and an overtube. For medications, there was agreement for having hyoscine butylbromide and epinephrine on the cart. For therapeutic/diagnostic tools, there was agreement for having biopsy forceps (standard and jumbo), polypectomy snares, sclerotherapy needles and agent (for a variceal bleed), band ligation kit, multipolar electrocautery probes, heater probe catheter, endoscopic clips, hemostatic powder and retrieval devices.
INTERPRETATION CONCLUSIONS
This position paper provides guidance on the minimum standard of items that should be on an after-hours endoscopy cart. Standardization of equipment may help improve safety and quality of after-hours endoscopic procedures.

Identifiants

pubmed: 32905048
doi: 10.1093/jcag/gwz032
pii: gwz032
pmc: PMC7465551
doi:

Types de publication

Journal Article

Langues

eng

Pagination

222-227

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.

Références

J Can Assoc Gastroenterol. 2018 Mar 30;1(1):40-42
pubmed: 31294395
Ann Intern Med. 2010 Jan 19;152(2):101-13
pubmed: 20083829
Gastrointest Endosc. 2007 Jul;66(1):1-6
pubmed: 17591465
Endoscopy. 1997 Jan;29(1):I-VI
pubmed: 9083752
Radiology. 1983 Nov;149(2):401-3
pubmed: 6622682
Can J Gastroenterol. 2012 Dec;26(12):871-6
pubmed: 23248785
Dysphagia. 2004 Winter;19(1):18-21
pubmed: 14745641
Gastrointest Endosc. 2018 Apr;87(4):994-1002
pubmed: 29158179
J Clin Gastroenterol. 2018 Jan;52(1):36-44
pubmed: 27749635
J Hepatol. 2015 Sep;63(3):743-52
pubmed: 26047908
Am J Infect Control. 2016 Nov 1;44(11):1237-1240
pubmed: 27497824
Endoscopy. 2015 Jul;47(7):638-45
pubmed: 25590183
Gastrointest Endosc Clin N Am. 2002 Apr;12(2):185-204, v
pubmed: 12180153
J Clin Gastroenterol. 2014 Nov-Dec;48(10):e89-92
pubmed: 24326829
Hepatology. 2017 Jan;65(1):310-335
pubmed: 27786365
Gastrointest Endosc. 2011 Nov;74(5):971-80
pubmed: 21737077
Aliment Pharmacol Ther. 2011 Jul;34(2):166-71
pubmed: 21615438
Gastrointest Endosc. 2011 Jun;73(6):1085-91
pubmed: 21628009

Auteurs

Mandip Rai (M)

Division of Gastroenterology, Queen's University, Kingston, Ontario, Canada.

Mary Cooper (M)

Division of Gastroenterology, North Ontario School of Medicine, Thunder Bay, Ontario, Canada.

Scott Shulman (S)

Division of Gastroenterology, North Bay Regional Health Centre, North Bay, Ontario, Canada.

Dan Kottachchi (D)

Division of Gastroenterology, Guelph General Hospital, Guelph, Ontario, Canada.

Sandra Nelles (S)

Division of Gastroenterology, Trillium Health Partners, Mississauga, Ontario, Canada.

Mark Macmillan (M)

Division of Gastroenterology, Dalhousie University, Memorial University, Fredericton, New Brunswick, Canada.

Steven Heitman (S)

Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada.

Alan Barkun (A)

Division of Gastroenterology, McGill University and the McGill University Health Centre, Montreal, Quebec, Canada.

Frances Tse (F)

Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.

Lawrence Hookey (L)

Gastrointestinal Diseases Research Unit, Department of Medicine, Queen's University, Kingston, Ontario, Canada.

Classifications MeSH