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GI Chen, JR Love, DJ Leddin

Division of Gastroenterology, Department of Medicine, QE II Health Sciences Center, Halifax, Nova Scotia

BACKGROUND/AIMS: The purpose of this audit was to describe our experience working with an endoscopy unit nurse on call for emergency endoscopy. The QE II Health Sciences Center provides secondary and tertiary care to a catchement of 500,000 people and tertiary care to a similar number. An endoscopy nurse is on-call weekday evenings and all weekend to assist with therapeutic endoscopy. This has been in place in Halifax since 1994. A form is filled in each time the nurse is called.

METHODS: A retrospective review of all completed call-back forms between October 1997 and August 2003 was performed. Patient demographics, indications, procedure type, findings and the use of therapeutics were extracted from the completed data forms.

RESULTS: A total of 706 endoscopies were performed on 642 patients of which 389 (60.6%) were male and 253 (39.4%) were female. Mean patient age was 64.8 years. There is a trend towards increased frequency of call-back utilization from once every 3.97 days from October 1997 to September 1998 to once every 3.17 days from October 2001 to September 2002. 91% of all procedures were upper GI endoscopies, 5% were lower GI endoscopy and 4% were ERCP. Of the upper GI endoscopies, 81% were for acute GI bleeding and 19% were for foreign body extraction. Within patients with upper GI bleeding, age > 60 was the indication in 87%, hemodynamic instability in 51%, co-morbid conditions in 48% and hematemesis in 40%. Therapeutics was performed in 43.2% of procedures.

CONCLUSIONS: In our center we utilize the nurse on-call about once every three days. The frequency has increased slightly over the years. The main indication is GI bleeding but the on-call nurse also provides valuable assistance in ERCP, foreign body extraction and emergency colonoscopy. Therapeutics are required in almost half of all patients. These procedures require specialized equipment and, in our experience, a trained nurse is essential.

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