By Douglas A. Drossman, Ian S. Grimm, Nicholas J. Shaheen
The completely up-to-date and enormously elevated Fourth version of the best-selling Manual of Gastroenterologic Procedures covers all diagnostic and healing strategies in present use for grownup and pediatric sufferers. Fifty procedures—both endoscopic and non-endoscopic—are defined in a concise, established, easy-to-follow layout that incorporates symptoms, contraindications, sufferer instruction, apparatus, method, post-procedure care, and issues. Over a hundred drawings advisor readers via key steps.
This variation comprises new diagnostic approaches and plenty of new healing endoscopy chapters. Appendices supply info on organizing a strategy unit, dealing with specimens, doses of GI medicines, guidance for endoscopic screening and surveillance, and CPT codes, plus a list of significant apparatus proprietors and Websites.
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Extra resources for Handbook of gastroenterologic procedures
Perform vital signs every 3 to 5 minutes immediately following the procedure. 2. Document the procedure with a note that includes the indications for the procedure, the details of procedure performed, medications administered, findings, and recommendations. Chapter05 3/2/05 9:37 AM Page 36 36 SECTION II. Basic Techniques 3. Give nothing by mouth until the gag reflex and sensation in the throat return. 4. The patient should not drive for 6 to 8 hours after conscious sedation. Detailed instructions should be given since many patients do not recall verbal discussions after sedation.
Acutely perforated ulcer or perforated esophagus 7. Atlantoaxial subluxation Relative 1. Uncooperative patient 2. Coagulopathy a. Prothrombin time 3 seconds over control b. Partial thromboplastin time (PTT) 20 seconds over control c. Bleeding time > 10 minutes d. Platelet count < 50,000/mm3 3. Myocardial ischemia 4. Thoracic aortic aneurysm PREPARATION 1. The patient should have nothing by mouth for 6 to 8 hours prior to the procedure. If this is not possible due to the need for emergent EGD, the stomach should be evacuated by means of an orogastric lavage.
2. Andersen long-weighted sump tube (AN 20) 8 ft (244 cm), 16 Fr with a tungsten-weighted distal capsule tip that relies on peristalsis to advance the tube. Designed to be passed transnasally, it can offer an alternative to the Rhefus and Einhorn tubes for diagnostic duodenal aspirations. Low intermittent wall suction diminishes likelihood of damage to the intestinal mucosa. The weighted capsule is easily identified on x-ray for fluoroscopic intubation. 3. The Andersen-type tubes have replaced the older, mercurybased Cantor and Miller-Abbott tubes because of safety issues.
Handbook of gastroenterologic procedures by Douglas A. Drossman, Ian S. Grimm, Nicholas J. Shaheen