Advanced Digestive Endoscopy: Practice and Safety by Peter B. Cotton

By Peter B. Cotton

Crucial new identify within the complicated Digestive Endoscopy seriesAdvanced Digestive Endoscopy: perform & security offers a pragmatic guide on the best way to practice suggestions correctly and successfully with the intention to maximise worth, and to lessen dangers. essentially established, it covers education, endoscopy and imaging apparatus, an infection keep watch over, sufferer coaching and tracking, problems and the way to prevent and care for them. increasing at the content material of Peter Cotton’s best-selling sensible Gastrointestinal Endoscopy, this instructive quantity includes details and directions on all features of the perform of endoscopy, and is a perfect significant other for either the trainee and the skilled endoscopist.Key positive factors include:Written by means of the best overseas names in endoscopy textual content has been expertly edited through Peter Cotton right into a succinct and instructive layout offered in brief paragraphs based with headings, subheadings and bullet issues Richly illustrated all through with full-color images

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The endoscopist must have a thorough knowledge of the pharmacology of the agents used for sedation and the training necessary to recognize and manage oversedation. Numerous regulatory groups are carefully scrutinizing the practice of sedation and analgesia. It appears that ventilatory monitoring will be required for at least a subset of our patients. Although both hypercapnea and apnea can be reliably measured, the most important questions to be answered are: will such monitoring affect patient outcomes, and which patients are at risk for apnea and alveolar hypoventilation.

Qxd 22/01/2008 09:35 AM Page 31 DESIGN AND MANAGEMENT intra-abdominal procedures. The latter are becoming known as natural orifice transenteric surgery (NOTES) procedures. At the present time, basic EMR is growing in the form of saline-assisted polypectomy; however, more advanced EMR of very large lesions and ESD of superficially malignant lesions requires lengthy procedures that are not easily adapted to existing Western practices and will likely remain in the hands of tertiary endoscopists. Transgastric NOTES procedures remain highly investigational and many anticipate they will be adopted by general laparoscopic surgeons more readily than by gastroenterologists.

If unscheduled procedures are infrequent this activity may be easily absorbed into the existing workday calendar. Many units leave the after-hours technical role of set-up, reprocessing, and procedural assisting to the endoscopist or trainee plus available float staff; however, this diminishes both quality and safety of the procedure and potentially the efficacy of reprocessing. Some units schedule a part time late shift that routinely covers those scheduled procedures that run late plus all emergencies until the morning.

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