Monitoring and safety in endoscopy

Over 50% of the complications and 60% of the deaths associated with upper GI endoscopy are cardiopulmonary in type. Oxygen desaturation and cardiac arrhythmias at the time of endoscopy are common. Ways of trying to prevent hypoxia occurring are discussed. The most effective of these is the use of supplemental oxygen. Pulse oximeters are being used increasingly frequently by endoscopists. The way in which oximeters work is described in some depth, as are some of the potential errors that may result from their use. The author believes that, as in anaesthetic practice, pulse oximeters will be used ever more frequently by endoscopists and finally become standard equipment in all endoscopy units. The case for using continuous ECG monitoring and blood pressure measurement is briefly discussed. The ASGE have recently published their recommendations on monitoring patients undergoing GI endoscopic procedures. The BSG's own working party on safety and monitoring is in the process of finalizing its recommendations, and the final part of the chapter discusses the views of this working party and gives some insight into what its final recommendations are likely to be.