FES Flashcards
No light at distal end
- Light source plug - Plugged in & on.
- Not in stand by mode.
- Clean scope tip.
- Burnt out Bulb.
- Dirty distal lens.
Irrigation solution
Sterile water
Saline crystallizes in channel
Out of focus
- White balance
- Clean lens
No irrigation
- Bottle contains water
- Bottle connected to umbilical cord
- Connection too tight
- Bottle lid too tight
- Power on
- Occluded/stuck valve
No insufflation
- Umbilical cord seated in light source. Needs to be screwed in
- Power turned on
- Stuck/Occluded valve
Clogged valve/nozzle
- Clean valve
- Flush channel with cleaning solution, followed by clean water
Unable to pass instrument
- Correct size selected
- Instrument tip closed
- Decrease tip deflection
Routine “high level disinfection”
Gluteraldehyde
Disinfection doe not work with foreign materials
Sterile “Overnight” cycle
Ethylene Oxide Gas
Location of suction port
5 - 7 O’Clock
Cart
- Monitor
- Video processor
- Light source
- Water bottle
- Image printer/recorder
Umbilical cable
Air & water valve
Umbilical cable - Partial depress
Air
Umbilical cable - Complete depress
Cleans lens
Withdraws air to force water into camera
Light cord
Coherent stacks of optic fibers
Positioning: ERCP
Prone with head to right
Left lateral decubitus if difficulty intubating duodenum
Supine: Associated with higher difficulty in intubating the papilla
Positioning: Colonoscopy
Left lateral decubitus
Positioning: APR
Supine
Fiber optic endoscope
Fragile
Fibers break = Dark spots on screen
Bronch and choledocoscopes only
Video endoscopes
Contraindication: Stricture (Can test with dummy pill)
Pregnancy
MRI
Dysphagia (Can endoscopically be placed in stomach)
Prep: NPO x 8hrs
Simethicone, Reglan, PEG
Timing of endoscopy in ESRD
Day after HD
Risk during Colonoscopy
Minor: Hypoxia (5.6%), hypotension, bradycardia, arrhythmia
Preprocedural labs
None
Cardiac Hx: EKG
Respiratory Hx: CXR
Coags: Hypocoaguability
General anesthesia: Pregnancy screen
Iso-osmotic (Polyethlene glycol PEG)
Safe in CHF, ESRD, Elecrolyte abnormaities, Liver disease