Esophagogastroduodenoscopy - Essay Example

? Esophagogastroduodenoscopy (EGD) Esophagogastroduodenoscopy (EGD), A1. Introduction/Procedure Esophagogastroduodenoscopy (EGD), synonymously known as upper endoscopy or gastroscopy, is a pre-operative procedure that examines the status of the esophagus, stomach, and duodenum. In an EGD, an instrument (endoscope) which is flexible, tubule and with a tiny camera at its tip is normally used in surgeries. It is used to generate images of the upper digestive system that are usually viewed from a computer screen in the examination room. In other cases, biopsies are performed in which small instruments are passed through the tube to treat disorders. Esophagogastroduodenoscopy practice comprises general anesthesia, indications and contraindications, techniques, as well as requirements (Mayeaux, 2009). Although the practice is associated with minimal adverse effects over, it is uncomfortable and has several complications as well as risks. A2a. Basis for the Practice This medical routine is performed by a proficient medical practitioner in esophagus and gastro-system surgeries. It is normally done as a way of treating symptoms that are related to the upper gastrointestinal tract. Recent studies noted with great concern that EGD may cause several complications, including stomach perforations, and peptic ulcers as post-operation side-effects. Other complications are related to contaminated equipments, topical anesthetics and sedation, as well as cardiovascular complications. Therefore, it is important to improve the procedure in the attempt to eliminate or minimize these complications (Talley, DeVault, & Fleischer, 2011). A2b. Rationale Esophagogastroduodenoscopy normally ascertains whether a patient needs treatment before the surgery is performed. It is an essential technique for treating endoscopic varicose in Cirrhosis patients, and making a diagnosis of various abnormalities of the upper gastrointestinal tract. It is normally used as a form of radiological study. Upper endoscopy helps in evaluation of symptoms of nausea, difficulty in swallowing, vomiting or persistent upper abdominal pain. Further, advantages that accrue from EGD necessitate its procedural consideration. It is the utmost method used to figure out the source of hemorrhage from the upper section of the gastrointestinal tract. In addition, it is more precise with higher performance in the detection of inflammation as well as tumors and ulcers of the duodenum, esophagus and stomach compared to X-ray. A2c. Explanation The practice of pre-operative upper endoscopy has been in existence for several decades in surgical practice. It is an essential component and procedure in evaluating a preoperative procedure for bariatric surgery. In current surgical practice, EGD is used to treat and evaluate symptoms of the upper gastrointestinal tract characterized by pain in the chest or upper abdomen, gastro esophageal reflux disease, difficulty swallowing, bleeding from the upper intestinal tract and related anemia, black stools or heartburn, and regurgitation among other indications. It may also to identify enlarged veins (called varicose veins) in the walls of the lower section of the esophagus, take samples for biopsy use, or ascertain abnormalities discovered by other diagnostic processes. This practice is used in surgical procedure since it provides better, more clear and detailed information that are used in surgical practice. It enables treatment without necessary conducting a surgery through the endoscope, biopsy forceps and other instruments (Cohen, 2011). A3. Reference List Aymaz, S., Krakamp, B., Kirschberg, O., & Lefering, R. (2010). Comparability of localization data in transnasal and transoral esophagogastroduodenoscopy. BMC Gastroenterology , 10 (116), 1-5. Cohen, J. (2011). Successful training in gastrointestinal endoscopy. Chichester: John Wiley & Sons. Mayeaux, E. J. (2009). The essential guide to primary care procedures. Philadelphia: Lippincott Williams & Wilkins. Talley, N. J., DeVault, K. R., & Fleischer, D. E. (2011). Practical Gastroenterology and Hepatology: Esophagus and Stomach. New York: John Wiley & Sons. Yusuf, T. E., & Katz, J. (2011). Esophagogastroduodenoscopy. Retrieved March 15, 2012, from http://emedicine.medscape.com/article/1851864-overview#a30 A4. Clinical implications of Esophagogastroduodenoscopy The further use of esophagogastroduodenoscopy procedure will advance the risk of damaging internal body organs such as perforating the esophagus, stomach or duodenum. It may expose patients to the threat of blood loss at the biopsy site, and side effects of medications given which may lead to Apnea, respiratory depression, excessive sweating, spasm of the larynx and low blood pressure. In addition, anesthetics and movement of the endoscope in the abdomen might cause serious physical consequences. On the other hand, the procedure will make ease the surgical procedure. Talley, DeVault, and Fleischer argue that upper endoscopy ensures fast, accurate diagnosis and treatment, although acquisition of equipments used in this procedure such as endoscopes translates to additional financial expenses. A5. Procedural changes In the attempt to enhance cost-effectiveness and efficiency of the procedure, enhancements in gastrointestinal endoscopic training and endoscopic design are necessary. The advancement of endoscopes into smaller caliber as well as more flexible tools will not only improve endoscopy outcomes but will also reduce complications. Prior test preparations should be emphasized in which patients conditions will be evaluated, informed consent established and other requirements fulfilled (Talley, DeVault, & Fleischer, 2011). A6. Stakeholders Several stakeholders will be engaged in execution of the procedural changes, including hospital administration, patients, nurses, and physicians. Patients must be well-versed with information on preparations and requirements, benefits, complications, as well as risks associated with the procedure to ensure voluntary participation, and elevate success levels. Health centers management, nurses and physicians must obtain evidence-based guidelines and findings that indicate risks as well as remedies of the routine’s complications. Hospital administration must incorporated new technology in endoscopy, which is more advanced and effective. B1. Translation of Research/Barriers It is apparent that several intricacies will be encountered in adopting the procedural changes in the preoperative surgical procedure. With the current hospital’s strained budget, it will be difficult to acquire the expensive equipments as well as recruit additional personnel; technicians, nurses and physicians. The process may be time consuming and labor intensive, especially where personnel require training or new infrastructure and equipments. In view of the fact that implementing these changes in endoscopy affects hospital’s policy, deliberations made in the practice review committee may impede translation of the research. Besides, physicians, nurses and management’s opinions and preference may be detrimental to the process. The hospital may get a tarnished name due to failures in operations, thus, they may see the changeover as insignificant (Classen & Tytgat, 2010). B2. Barriers in instituting change The medical personnel may be resistant to change clinical procedures that have been use for a while now. This is because of failure of them embracing change. The patients may aloes not be able to give some of their information and medical history to the doctors as they fear victimization and view it as confidential, hence, the doctor will treat the patient normally while in essence, he or she is a high risk patient. B3. Mitigation Strategies A meeting needs to be conveyed to educate the staff to understand the shortcomings of EGD and come up with a blueprint on how to address the issue. This may be looking for an alternative means for example, Transnasal EGD that would reduce the risks. The staff should be informed in advance of the changes to be instituted so as to be psychologically prepared for re-training and the research they would carry out. B4. Implementation Strategies Research should be done on better and safer cost-effective alternative mechanisms for EGD. This may include investing in new systems and machines for Transnasal EGD, Retraining of medical staff as well as c conducting awareness campaigns to the community at large on the importance of healthy lifestyles, and the ways of diagnosing gastrointestinal disorders before they advance. References Aymaz, S., Krakamp, B., Kirschberg, O., & Lefering, R. (2010). Comparability of localization data in transnasal and transoral esophagogastroduodenoscopy. BMC Gastroenterology , 10 (116), 1-5. Classen, M., & Tytgat, G. (2010). Gastroenterological Endoscopy. New York: Thieme. Cohen, J. (2011). Successful training in gastrointestinal endoscopy. Chichester: John Wiley & Sons. Mayeaux, E. J. (2009). The essential guide to primary care procedures. Philadelphia: Lippincott Williams & Wilkins. Talley, N. J., DeVault, K. R., & Fleischer, D. E. (2011). Practical Gastroenterology and Hepatology: Esophagus and Stomach. New York: John Wiley & Sons. Yusuf, T. E., & Katz, J. (2011). Esophagogastroduodenoscopy. Retrieved March 15, 2012, from http://emedicine.medscape.com/article/1851864-overview#a30 Read More