Gastrointestinal endoscopy clinics of North America
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The 21(st) century has witnessed burgeoning interest in airway management. Pertinent basic sciences are covered in numerous texts and lectures. ⋯ It serves as a primer for those interested in learning airway management skills. It does not replace extensive practice under the tutelage of expert airway managers.
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Gastrointest. Endosc. Clin. N. Am. · Oct 2008
ReviewHuman patient simulation and its role in endoscopic sedation training.
Patient simulation is now considered to be a valid method for the education and evaluation of providers of sedation. Using full-scale human simulators to provide a realistic setting, participants can acquire skills for patient monitoring, administration of sedation medications, and the recognition and management of critical events. Although obstacles to its implementation exist, it appears likely that simulation training will become an integral part of training for providers of procedural sedation.
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Best sedation practices for pediatric endoscopy involve the consideration of many patient factors, including age, medical history, clinical status, and anxiety level, as well as physician access to anesthesia support. A recent survey of pediatric gastroenterologists suggests that endoscopist-administered intravenous (iv) sedation and anesthesiologist-administered propofol represent common sedation regimens in children. Technical advances in ventilatory monitoring are contributing to increased patient safety for all children undergoing gastrointestinal procedures, regardless of sedation type.
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Gastrointest. Endosc. Clin. N. Am. · Oct 2008
ReviewGastroenterologist-directed propofol: an update.
Gastroenterologist directed propofol has been proven safe in more than 220,000 published cases. Administration of low doses of opioid and/or benzodiazepine ("balanced propofol sedation") is the safest format for gastroenterologist directed propofol. Specific training is needed to undertake gastroenterologist directed propofol administration.
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The role of sedation in endoscopic procedures has increased and so has the demand for advances in its administration. The pursuit of new agents or administration techniques and their study specific to endoscopic nonsurgical procedures is necessary to improve patient comfort and safety. The science of moderate and deep sedation specific to endoscopy is fledgling but approaching new horizons.