Bedside EGD

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Ttan

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Do intensivists ever get certified to perform their own emergent bedside EGDs on GI bleeders?

The ASGE publishes specifications for non-GI endoscopists here:
https://www.asge.org/docs/default-s...ileging_credentialing_proctoring.pdf?sfvrsn=8

I know some people go for GI/CCM fellowships, but wouldn't it be nice to be able to scope all those bleeders without having to be a GI? Specially in the middle of the night.

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I'm happy to let the guys who scope all day, erry day do the scoping. When it needs to save a life best to have the best guy in the room working the scope
 
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The patient who is sick enough to require a bedside EGD in the ICU is likely actively exanguinating. Let the GI do what they are good at (using their camera guided rubber band gun) saving the intensivists for what they are good at (resuscitating a dying patient)
 
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Do intensivists ever get certified to perform their own emergent bedside EGDs on GI bleeders?

The ASGE publishes specifications for non-GI endoscopists here:
https://www.asge.org/docs/default-s...ileging_credentialing_proctoring.pdf?sfvrsn=8

I know some people go for GI/CCM fellowships, but wouldn't it be nice to be able to scope all those bleeders without having to be a GI? Specially in the middle of the night.


If you’re a surgical intensivist, yes. I’d rather have GI do it though
 
In a liver transplant ICU? Then, if I was a surgeon I might might might consider something like this...but not really.

In all other units, this is misguided and a time waste, IMO.

There are so many other skills and "procedures" that could be mastered in an equal amount of time that would be used usefully SO much more frequently.

HH
 
The practical-ness of this would be so low. It's like nearly every UGI bleed I've ever seen, Me: "Do you think this patient needs a scope", GI: "Oh, they are too sick and all I'll see is blood. Just make them NPO, Octreotide and a PPI and we'll see them tomorrow". The next day Me: "Well the crit is stable and we've stopped the Octreotide, do you think this patient needs a scope", GI: "Oh, well the patient has clearly improved and I wouldn't want to dislodge a clot. Just keep the PPI going and we'll see them tomorrow". Rinse, repeat.
 
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The practical-ness of this would be so low. It's like nearly every UGI bleed I've ever seen, Me: "Do you think this patient needs a scope", GI: "Oh, they are too sick and all I'll see is blood. Just make them NPO, Octreotide and a PPI and we'll see them tomorrow". The next day Me: "Well the crit is stable and we've stopped the Octreotide, do you think this patient needs a scope", GI: "Oh, well the patient has clearly improved and I wouldn't want to dislodge a clot. Just keep the PPI going and we'll see them tomorrow". Rinse, repeat.

Adult GI docs will scope anything. As long as it's not too too early in the morning. But by 7am for sure!!
 
I'd put this in the category with perc trachs. Sure, you can learn to do them and even fool yourself into thinking it is within your scope of practice, but why? Why would you want to assume liability for someone you reasonably can't get yourself out of trouble doing? Let the people who play with those devices all day do that stuff. They will do it faster and likely safer than you will, and if an answer can be achieved they are likely to achieve it.
 
I'd put this in the category with perc trachs. Sure, you can learn to do them and even fool yourself into thinking it is within your scope of practice, but why? Why would you want to assume liability for someone you reasonably can't get yourself out of trouble doing? Let the people who play with those devices all day do that stuff. They will do it faster and likely safer than you will, and if an answer can be achieved they are likely to achieve it.

I wouldn't put this in the same category as perc trachs. There's enough evidence out there to support intensivists doing them. I have seen some for PEGs and I have also heard of at least one program that lets their fellows do some PEGs in fellowship. But I haven't seen/read much about intensivists performing EGDs.
 
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