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Our notes on how to counsel patients here!
Explain what the procedure is
Explain the reason for the procedure
Before
- Oral intake
- 6 hours before – clear fluids (sips) only
- 2 hours before – NBM
- Also
- Coagulation test
- Stop antiplatelets 1 week before (unless high risk, e.g. drug-eluting stent)
- Stop warfarin 5 days before (± give LMWH)
- Stop direct oral anticoagulants 48 hours before
During
- Midazolam sedative (→amnesia)
- Lidocaine spray/gel to the nose, throat and windpipe
After
- No eating/drinking 2 hours after as throat still numb
- No driving, alcohol, operating machinery, or signing legal documents for 24 hours
- Keep someone with you for 24 hours
- Arrange follow-up
Risks
- Lung damage/collapse
- Infection
- Bleeding (haemoptysis)
- Sore nose/throat
- Sedation side effects
- Pneumothorax
Explain what the procedure is
Explain the reason for the procedure
Before
- Oral intake
- 6 hours before – sips of water only (sips)
- 2 hours before – NBM
- Also
- Stop acid suppressive medications 2 weeks before
During
- Lidocaine throat spray or midazolam sedative (→amnesia)
- Continuous suction
- Air passed through scope (→fullness, belching)
After
- Arrange follow-up
- If had throat spray
- No eating/drinking 2 hours after as throat still numb
- If had sedation
- No driving, alcohol, operating machinery or signing legal documents for 24 hours
- Keep someone with you for 24 hours
Risks
- Perforation (<0.1%)
- Bleeding
- Infection (aspiration pneumonia)
- Sore throat
- Dental damage
- Sedation side effects
Explain what the procedure is
Explain the reason for the procedure
Before
- Oral intake
- 2 days before – low fibre diet (no bran/roughage)
- 1 day before – clear fluids only after light breakfast
- 2 hours before – NBM
- Also
- Sodium picosulfate sachet afternoon before and morning of the procedure
- Stop iron tablets 1 week before, and constipating agents 4 days before (e.g. codeine)
During
- Midazolam sedative (→amnesia)
- Digital rectal examination prior to scope insertion
- Air passed through scope (→bloating, you may feel like you need to go to the toilet)
After
- No driving, alcohol, operating machinery, or signing legal documents for 24 hours
- Keep someone with you for 24 hours
- Arrange follow-up
Risks
- Perforation (0.1%)
- Bleeding
- Infection
- Abdominal discomfort
- Sedation side effects
Explain what the procedure is
Explain the reason for the procedure
Before
- Oral intake
- Also
- Phosphate enema 2 hours before (can be self-administered at home)
During
- Digital rectal examination prior to scope insertion
- No sedation required
After
Risks
- Perforation
- Bleeding
- Infection
- Abdominal discomfort
Explain what the procedure is
Explain the reason for the procedure
Before
During
- Anaesthetic jelly
- Water passed through scope
After
- Home after passed urine
- Arrange follow-up
Risks
- Bladder damage (hole)
- Bleeding (haematuria – normal for a few days)
- Infection (UTI)
- Dysuria
- Urethral stricture
- Retention
- May need temporary catheter afterwards
Explain what the procedure is
Explain the reason for the procedure
Before
- Oral intake
- 6 hours before – clear fluids only
- 2 hours before – NBM
- Also
During
- Usually have anaesthetic
- Water passed through scope
After
- Home after recovered from anaesthetic and passed urine
- No driving, alcohol, operating machinery, or signing legal documents for 24 hours
- Keep someone with you for 24 hours
- Arrange follow-up
Risks
- Bladder damage (hole)
- Bleeding (haematuria – normal for a few days)
- Infection (UTI)
- Dysuria
- Urethral stricture
- Retention
- May need temporary catheter afterwards
- Anaesthetic side effects
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