Download Advanced Digestive Endoscopy: Practice and Safety by Peter B. Cotton PDF

By Peter B. Cotton

Crucial new name within the complex Digestive Endoscopy seriesAdvanced Digestive Endoscopy: perform & safeguard presents a realistic handbook on easy methods to practice recommendations adequately and successfully that allows you to maximise worth, and to lessen hazards. essentially based, it covers education, endoscopy and imaging apparatus, an infection keep an eye on, sufferer coaching and tracking, issues and the way to prevent and take care of them. increasing at the content material of Peter Cotton’s best-selling useful Gastrointestinal Endoscopy, this instructive quantity includes details and instructions on all features of the perform of endoscopy, and is a perfect spouse for either the trainee and the skilled endoscopist.Key beneficial properties include:Written through the top overseas names in endoscopy textual content has been expertly edited via Peter Cotton right into a succinct and instructive structure provided in brief paragraphs based with headings, subheadings and bullet issues Richly illustrated all through with full-color photos

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BIS monitoring Bispectral index (BIS) monitoring represents a complex mathematical evaluation of electroencephalographic parameters of frontal cortex activity, corresponding to varying levels of sedation. The BIS scale varies from 0 to 100 (0, no cortical activity or coma; 40–60, unconscious; 70–90, varying levels of conscious sedation, 100, fully awake). Theoretically this index should reflect the same level of sedation regardless of the medications used, except for ketamine. In a preliminary observational study involving 50 patients undergoing ERCP, colonoscopy, and upper endoscopy, BIS levels were found to correlate with a commonly used score for the degree of sedation [9].

Many commonly used devices such as biopsy forceps and single-channel sphincterotomes have reached a commodity status, in that their function and design by different manufacturers are all similar and adequate. This has driven unit costs for single-use designs down to the point where they are cost competitive with the reusable alternatives. Reusable devices typically reduce costs, but require ongoing administration of reprocessing capabilities, including training, quality assurance, risk, etc. Device costs can be constrained by: 1 the willingness of endoscopists to designate which items are commodities and which are not; 2 willingness to use the lowest cost commodity items; 3 use of an open bid process for competing vendors to propose their best offers based on projections of both uniform large-volume purchasing and singleunit purchasing; 4 purchasing through one of several purchasing collaboratives, which many hospitals participate in across multiple specialties and types of equipment and supplies; 5 concerted effort by physicians and nurses to avoid intraprocedural wastage of expensive items.

An over-tube may be used to retard gastric looping and enhance insertion depth [5,9]. List prices range from $23 800 to $33 275. Double balloon enteroscopy (Fijinon Corp, Tokyo) incorporates an iteration of an enteroscope modified with an inflatable/deflatable balloon recessed at its tip used in combination with a flexible overtube similarly balloon-equipped. Under combined endoscopic and fluoroscopic guidance, the double balloon enteroscope and overtube are alternately advanced, fixed in position with their balloons, and undergo a tethered withdrawal.

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