Calling all GI nurses !!

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I've been lurking around this site for a couple years. This GI section is really sloooooow......

Where are you guys? Tell me about yourselves! Please! I'm so bored right now. :eek:

Me, I've been doing GI about 4 yrs. now. Prior to that I was a med/surg nurse. I've also worked in a family practice office and as a home health nurse (briefly).

I worked in the GI lab at a hospital for a year or so. Since then I've been working in an outpatient surgery center, which is heavenly! We only do upper/lower endoscopies. No bronchs/ERCP's or anything else. 99% of our procedures are diagnostic (vs. therapeutic) so I rarely see GI bleeds, food boluses, etc. anymore. Sometimes I actually miss that.....but....I DON'T miss taking call and working Saturdays! :chuckle

Anybody else alive out there???

Amy :)

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

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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 :)

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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?

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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 :)

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What is methemoglobanemia?????

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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

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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.

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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". :chuckle

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I've been doing endo for 6 yrs now.

We use anaesthesia routinely (using anaesthetists, so always 2 Drs in the room now days) - started doing so about 2-3 yrs ago, although some Drs still use Midazolam and Fentanyl.

We have recently stopped doing ERCPs at our hospital, due to the Drs not happy with facilites and the high level of complications (not nurse related!!!!)

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Hi all

Regarding the use of Cetacaine Spray, I'm an RN in an Endo unit where we use Cetacaine spray prior to EGD's. I'm currently working on a BN and I'm looking at Research in Health Care/ Evidence Based Practice, in particular the use of Cetacaine Spray,why we use it [other than the obvious reasons] what research guides our practice or do we do it because we are told to? do any of you GI Nurses have any info or or can you guide me in the direction of some research? if there is any.:nurse:

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Do the Nurses not give the Sedation? And what kind of complications were happening?

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Hi Brit999,man it's wonderful to hear from other GI nurses!!! From what my doctors have told me the reason why we use cetacaine/hurricaine spray is for pt comfort. The spraying numbs the back of the throat decreasing gag reflex. But along with that pt's under sedation tend to "lean back" and since they have lost the ability to feel saliva they could actually choke.I have used the "beads" before but they cause nausea.

As far as sedation myself and my fellow RNs at my office do give sedation,fentanyl and versed.Out of six mds, only one gives starting meds. But after the procedure has started the rn takes over giving the meds.

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