Harbor:ED Endoscopy

• Consult GI
  • Emergent EGDs should occur either in the ICU or be redlined to the OR (GI will communicate with trauma/anesthesia to establish emergent case priority)
    • Consider Blakemore/Minnesota tube placement
    • ICU team will perform airway management during the daytime; after hours, the patient can either be intubated in the ED or by the airway team in the ICU

• • Urgent EGDs should go to the endoscopy suite or be admitted and scheduled next day by GI (target endoscopy time <8 hours from presentation)
    • Stable GI Bleeders – transfuse as needed, admit to medicine; GI will arrange for endoscopy suite as the preferred procedural location
    • Foreign body retrieval – to occur in the endoscopy suite; if after hours and anesthesia is unavailable, admit to medicine for GI to schedule in the endoscopy suite; if emergent (magnets, button batteries, etc), these should be redlined to the OR
    • Psych patient - may consider ED endoscopy if end disposition is psych ED instead of inpatient

• • Intubation vs procedural sedation
    • If a patient is intubated for a procedure, you are no longer providing procedural sedation and the bedside nurse can titrate medications to ensure the patient is adequately sedated