6. Upper GI Endoscopy: Step by Step
Recognize the landmarks
Art of reaching each landmarks
7. Pre Endoscopic Ritual 1
Equipment check list:
Endoscopy leak tested and disinfected and
ready
Processor unit, monitor working
Water bottle full and suction unit ready
Check suction, air flow and water flow
Mouth guard
Accessories stand by
8. Pre Endoscopic Ritual 2
Patient check list:
Know the indication
Verify any contraindication
Drug history and co morbidity
Informed consent
Fasting for 6 hours
No denture or loose tooth
9. Success depends on Sound
Basics
Ambidextrous
Left hand on control head
Right hand on endoscopy shaft
Benefit of body movement
Ergonomics during endoscopy
14. Language of the Wheels/Buttons
•Big Wheel
•Small Wheel
•Towards you
•Away from you
•Superior button
•Suction
•Inferior Button
•Insufflation of air
•Instillation of water
15. Language of the Insertion tube
•Clock wise twist
•Anti-clock wise twist
Navigate using
•Wheel
•Shaft &
•your Body
26. Puddle of fluid greets you!
Enter the body of stomach
1st
,,,,,,,
27. Inspect/suction any residue and insufflate and orient yourself: remember the clock
Lesser curve : 12 o clock
Greater curve: 6 o clock
Anterior wall : 9 o clock
Posterior wall : 3 o clock
12
6
9 3
28. Steps of Endoscopy 6
Greater curve at 6 o clock position
Posterior wall at
3 O clock
Anterior wall
At 9 o clock
Enter along the long route
Exit along the short route
Lesser Curve at 12 o clock
29. Big wheel towards you
Clockwise twist of shaft
Push the scope
3 Times!
47. Abandon the procedure
When patient is restless/ not co- operative
Any indication of cardio respiratory distress
Any indication of major complication
Perforation/false passage/aspiration etc
48. Post endoscopic steps
Endoscopy:
Cleaning and disinfection
Patient:
Discuss the findings and their implications
Give a written report
Advice regarding further management
49. Patient instructions after
the procedure
•No solid foods for 30 minutes after the examination.
• Allow for after effects of sedation
(no driving, no hazardous work activities for 24 hours).
• Report any complications (pain, bleeding, fever).
50. Safety During Endoscopy
Pre endoscopy check list
Vigilance during endoscopy
Administer Nasal O2
ECG/Pulse Oximeter
Need for anesthetist
Access to Defibrillator/Resuscitation team
Disinfected Endoscope and accessories
Safety of Patient Safety of Staffs Safety of Equipments