OSCE - explaining a gastroscopy Flashcards
What is an OGD
It is a procedure we use to examine the inside of your gullet (food pipe), stomach and upper part of your small intestine. We put a long, thin flexible tube called an endoscope into your mouth and pass it down into your stomach. The endoscope is thinner than your little finger and has a camera in its tip which sends pictures of the inside your stomach and intestine to a video screen.
Why is it done?
Visualise OGD to check that everything is healthy
If anything unusual, can take a small sample to send to the lab for analysis
Benefits
Can confirm diagnosis
Ensure you are on right treatment
If polyps -> no surgery, can remove them during this procedure
Stretch out narrowings
Deal with internal varicose veins
Risk
Extremely safe procedure and complications are very
rare. But they can include:
- Sore throat
- Dislodged teeth, crowns or bridgework
- Bleeding –> more common in biopsy and should only last a few seconds
- Perforation –> tiny risk, higher if using balloon to stretch out narrowing. Might need CT + repair surgery (wouldn’t be able to repair there and then)
- Pneumonia –> higher risk in COPD, bronchitis and emphysema –> head to A&E if resp symptoms
- Reaction to the sedative –> smallest dose possible, if reaction we can quickly reverse it
What are the risks of having a sedative?
You may feel tired, dizzy or weak. You MUST have someone to collect you and stay with you for at least the first 12 hours (NOT TAXI). During the first 24 hours you should not:
* drive a car
* operate machinery (including kitchen appliances)
* drink alcohol
* take sleeping tablets
* sign legal documents
* look after young children and/or dependants alone.
Alternative?
Barium swallow Xray, but if abnormal, you would then have to have an OGD.
Preparation
Fast for at least 6 hours before
Clear fluids (water) up to 2 hours before
Preparation
Fast for at least 6 hours before
Clear fluids (water) up to 2 hours before
Don’t bring children
Valuables with you
Bring glasses if you wear them (read and sign consent form)
What happens before the test?
- Doctor puts cannula in hand -> sedative
- Into room -> spray in back of throat
- Given oxygen
- BITE DOWN ON MOUTHGUARD
What happens during test?
nurse will be with you at all times
more than enough room for you to breathe
If the endoscopist takes biopsies, you will not feel this at all.
What happens during test?
nurse will be with you at all times
more than enough room for you to breathe
If the endoscopist takes biopsies, you will not feel this at all.
(see above for rationale of procedure)
How long does it take?
5min
What happens after the test?
How long it takes you to recover depends on whether you have had a sedative. But you should plan to spend the whole morning or afternoon of the test in the Endoscopy Unit.
If sedative = 30-45min until worn off
If no sedative, leave as soon as you are ready
Copy of report sent to GP
What happens when home?
If spray, don’t eat/drink anything up to 1hr
Try sips of cool water, if these work then drink and eat normally
Safety-netting
Please contact your GP if you have any of the following symptoms:
* Severe or continuous pain in your neck, chest or abdomen
* Persistent nausea or vomiting
* Passing black (tarry) stools
* Temperature of 37.4°C and higher, chills
