ACTIVITIES OF ENDOSCOPY NURSES Steps to Be Followed Pre, During and After Procedure While You Are In 50 Kuter Pre-Procedure Activities 1. Show Your Client’s Welcome Sign & Next Ask the Payment Receipt for the Procedure (Endoscopy or Colonoscopy). 2. After you identify the type of Procedure going to be done ….act accordingly … If it is Colonoscopy…………. 1. Teach & provide the paper how they will be prepared, 2. Give prescription for the drug they will take while on preparation, next 3. Appoint and write them on the appointment paper. If it is endoscopy …ask the client …… 1. Weather they have taken food, fluid or not ...if yes …ask the time … NB: - any client must be NPO 4-8 hrs. 2. Next, if your patient is NPO...For required time Proceed as following... Ask the client weather he/she have attendant Prescribe drug and equipment’s needed for the procedure and send the attendant to pharmacy , next After giving information regarding the procedure, Take consent, secure IV cannula, withdraw lidocaine in to syringe (for gurgle), and also the diazepam (for sedation)….bed making... Put your endoscope on the stand prepared for it and connect video scope in adapter on the endoscope… Do leakage test...while you’re doing leakage test ( 3-5min) Gather and put equipment’s like (mouth guard, kidney dish with water, & gauze,) on the table. After you finish leakage test, ( if passed -inflated pressure maintains in between 160-180) continue …as below Release the leakage test from the cap; then, connect suction tube from central suction system with bottle and suction tube with aspiration port on the scope, attach irrigation tube from water bottle to endoscope Power on the endoscope from back side to front, press lamp symbol, next press + sign until 50. Next press this , then press + until 2-3. Remove leakage tester cap from video processor port, and connect camera to the port (when connecting the camera with port, take note of the white marking both on the camera as well as on the endoscope). Connect suction valve, irrigation valve, biopsy valve to their appropriate port then check for functionality and patency by pressing alternatingly (suction valve & irrigation valve). During-Procedure Activities….starts with calling to the doctor After performing the above activities, call for the doctor, give the lidocaine 2-3ml (for gurgle), next if the doctor arrives …. Assist the patient to sleep on left lateral position (take left hands to back , if there is no problem doing this) Put mouth guard on the patients mouth after asking the client to open his/her mouth, then tell to hold with their teeth & not to release until the procedure completed ….give diazepam 5mg-10mg , then instruct the attendant to hold right hand on place Take the endoscope from the stand and give for the doctor….check (white balance) by pressing the button. Assist the doctor by instructing the patient to swallow & holding his/her head on the bed without applying unnecessary pressure, put gauze nearby, listen the doctors order carefully (if there is biopsy ,you to irrigate, press bubble tube & so on). Reassure the client as they are finishing the procedure & facilitate to breath with their nose When the scope reaches / pass duodenum/ pylorus give gauze for the doctor & look if he needs additional gauze… next When the scope reaches oral cavity -- After -Procedure Activities….. Starts when the scope reaches oral cavity & continues as following …. Removing mouth guard from patients mouth, Receiving the endoscope from the doctor , Immediately after receiving, start to remove any secretions from outer surface of the insertion tube with clean disposable moisten cloth or gauze. Then Insert the distal end in a container containing enzymatic solution & suck, clean the solution with distilled water in the kidney dish, next put the scope on the stand. After preliminary cleaning, star to disconnect the tube from the scope, remove camera from video processor port, and close video processor port with leakage tester cap, leakage test , After you finish leakage test, ( if passed –inflated pressure maintains in between 160-180) while doing this instruct the attendant to assist the patient to sit and continue …as below Cover the camera adapter with glove…..Disconnect the endoscope from video processor, & take it to instrument processing area, next immerse outer surface of the insertion tube in to enzymatic solution . Gather equipment’s needed for instrument processing like (v-shaped tube, syringe, brush)…after doing this tell attendant to support & take the client to physician , next Put on PPE (green gown, eye goggle, S/glove)...remove suction valve, irrigation valve , & connect v-shaped tube with their appropriate size of port , connect the syringe on v-shaped tube tip….then start irrigation until bubble clear . After bubble cleared , disconnect v-shaped tube & insert brush through suction valve port until whole part of brush get in , next remove & insert brush through suction tube adapter , then Re-attach v-shaped tube with their appropriate size of port; connect the syringe on v-shaped tube tip…lastly start irrigation until bubble clear. after this clean outer surface of the insertion tube with enzymatic solution, and Immerse into clean water ….perform cleaning steps like in enzymatic solution except brushing until bubble clear, after bubble cleared, clean outer surface of the insertion tube with clean water, proceed to next step ….. Immerse outer surface of the insertion tube into pre-prepared high level chemical solution…( how to prepare the high level is posted on instrument processing area )…. attach v-shaped tube with their appropriate size of port; connect the syringe on v-shaped tube tip …install 20-30ml of high level into the tube …wait for 10-15 min…while this minute reach …clean equipment to be reused, remove dirty linens , emesis basin content …lastly prepare the environment for next patient …..if you have another patient …do pre-procedure activities until your time reach ..if your time reach go back to instrument processing , Start irrigation until bubble clear, After bubble cleared , disconnect v-shaped tube & insert brush through suction valve port until whole part of brush get in , next remove & insert brush through suction tube adapter, then Re-attach v-shaped tube with their appropriate size of port; connect the syringe on v-shaped tube tip…lastly start irrigation until bubble clear. After this clean outer surface of the insertion tube with high level, proceed to next step... Immerse outer surface of the insertion tube into distilled water … start irrigation until bubble clear, After bubble cleared , disconnect v-shaped tube & insert brush through suction valve port until whole part of brush get in , next remove & insert brush through suction tube adapter, then clean outer surface of the insertion tube with high level, proceed to next ... distilled water. And perform the same step….lastly if the you have patient …perform …preprocedure activities as above or if you have no patient do leakage test and put the endoscope on the appropriate place…..complete your work .
