| Theme |
Patient Management During Endoscopic Examination and Treatment |
| Title |
Management of Patients Before, During and After Emergency Endoscopies ; Preparation, Premedication and Monitoring |
| Author |
Hiroshi Kashida |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Hiromasa Mine |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Masaki Takayama |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Yoshiaki Nagata |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Tomoyuki Nagai |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Masanori Kawasaki |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Yutaka Asakuma |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Toshiharu Sakurai |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Shigenaga Matsui |
Division of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| [ Summary ] |
Indications for emergency endoscopy include gastrointestinal hemorrhage, choledocal stone impaction, etc. Contraindications include shock, gastrointestinal perforation and other poor general conditions of the patient. While comprehending the morbidity by taking the patientʼs history and conducting a physical examination, blood examination and abdominal imaging, you should at the same time secure an intravenous line and try to improve the patientʼs condition. Informed consent for emergency endoscopy should be obtained, followed by preparation of scopes, endoscopic accessories, fluoroscopy equipment, cardiorespiratory monitors and other necessary instruments, as well as medication for resuscitation. Gastric irrigation or colonic cleansing should be done when necessary. Sedation is often necessary to ensure a smooth endoscopic examination and treatment, nevertheless care should be taken not to allow low blood pressure, hypopnea or pulmonary impact with food or blood. Vital signs should be monitored continuously before, during and after examinations. If use of endoscopy fails to relief morbidity, other examinations and/or surgical treatment should be considered. |