[LibraSun]

God, I would love to have MAC for ERCPs. Where are you that they are using anesthesia routinely? We still have to use Fent/demerol and Versed for those horribly loooooong ERCPs!! Our dept only has a tech for scopes. RNs do wires and sedation, which we rotate.

How can one work in a GI lab and not do ERCPs?

[ENDOgal]

Hello. I worked in step down ICU in a Trauma 1 hospital, then to Short Stay surgery (and cross-trained to relieve ENDO). I really liked the Short stay surgery but had a crappy schedule. So i went to ENDO when an opening came up. We start @ 0630 to set up ect. And usually start scoping between 070 to 0800. Normally.......we are done by 1300-1400, and leave.

We also have general anesthesia for our ERCP's. The RN only gets the wires ready, the Reno syringes ready ect. The LPN assist. WE do the EGDs & colons. We do not do the Bronch's yet......

[Jbahoffman]

Amy-- Why did you stop using Cetacaine Spray??

[EndoRN]

Jbahoffman,
2 of our MD's requested we stop using it. Evidently (I've not ever seen this happen) they had some cases of desaturation. I think it was called methiglobinemia (LOL. something like that...the O2 gets displaced from the cells.)

Amy

[patsue53]

We've all been trained in recognizing and treating methemoglobanemia but I've never seen it. I think it's very VERY rare. I'm surprised your docs have stopped using Cetacaine because of it. Do you spray with something else?

[EndoRN]

No. If we are doing someone unsedated or using IVCS then we have them gargle w/4% lidocaine. Otherwise we don't use anything. We have anesthesia sedation and they are so deep there's never any gagging.
They also can eat as soon as they wake up. Then leave.
I'm actually starting a new job (in additon to my current job at the surgery center). I'll be back in a hospital doing GI. I'm curious what they'll be doing.
I never saw that methemoglobanemia when I worked in a hospital before. I had actually never heard of it. The one MD who had it happen is our lab director. So when he freaked and told us to stop using it we didn't argue. We rarely used it anyway. Now if we have to numb them up, they gargle.

Amy

[Jbahoffman]

What is methemoglobanemia?????

[patsue53]

This article explains it better than I can. I know that it causes respiratory distress with cyanosis and when blood is drawn it looks like chocolate milk. It's treated with IV Methylline blue. I've never seen a case of it...hope I don't!


http://www.caep.ca/004.cjem-jcmu/004-00.cjem/vol-3.2001/v31-051.htm

There are also environmental issues that cause chronic cases of it, but I guess that's another forum. LOL

[miz annie]

I am from Springfield, Mo. I have been in Endoscopy for about 14 years now. I love it. I work in a hospital unit doing in-patients and out-patients and we see about 45 patients a day. We do ERCP's, PEG's, Esophageal and Anorectal Manometry, pH studies, bronchs with metal stent placement as well as using the Argon Plasma Coagulator in the lungs for tumor ablation. Of course there are the routine colons and gastros as well. We are opening a center off campus this next summer which will have 8 procedure rooms, 39 recovery rooms and only routine gastros and colons, manometry and pH studies will be done there. We are keeping 4 procedure rooms open at the hospital for all in-patients, ERCP's, Bronchs, PEG's and those at "high risk"! (ie severe COPD, etc.) I am CGRN certified since 1994 and a member of SGNA.

[CurvyGal]

HI all , I am new to nursing forum and will get you a short synopsis of who I am and what I do. I am a 1st Assist Tech (nope not an R.N) . I work in a hospital based endoscopy suite as well as the new free standing clinic ( joint venture between Doc's and hospital). I have been in GI services for 2 years and I do like my job. Of course just as with an job there are good days and bad days. We do EGD's , colons ,bronch's and ercp's as well as PEG placements. I look forward to some interesting thoughts and ideas from all the long time GI nurses and techs here in the forum. And always remember " If your not the lead dog, the view never changes".