Gi Clinical Observation

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During my GI observation day I was able to see 5 Colonoscopies, 3 esophagogastroscopies, and one patient had both procedures performed. I saw several polypectomies and biopsies. During an endoscopy I saw the DR cauterize an esophageal ulcer. It looked like a big white patch with a raised portion covered in yellow sputum . The DR explained that the ulcer was yellow because of bile and that the white part I saw was a crater. I’ve tried to find the correlation between the ulcer being yellow and bile but was unsuccessful (please explain when you have time). I learned that when the DR finds a polyp and wants to remove it, the Nurse gives him a snare. He then puts the tube down the colonoscope; while the nurse holds the end of the snare (looks similar to the end of a syringe). The nurse is actually the one who snares the polyp. Same when the biopsies are performed. The nurse controls the clamp. The DR maintained control of the colonoscope and gave the nurse instructions (open, close, snare,) then if it was a biopsy the nurse just pulled out the extra tube and the nurse dumped it into a specimen jar. If it was a polyp he sucked it up with the scope and it was caught in a tray attached to the camera. I noticed that the medication given before and during the procedure was 50 mcg/ml of fentanyl IV before and 40 mg of Diprivan during. The DR explained that Diprivan was the drug that killed Michael Jackson. I asked if after the procedure if any additional medication would be needed to reverse the effects while the patient was in recovery. He said no that it wears off fairly quickly. I overheard one of the nurses ask a patient if he was still drinking every day. She said patients who drink regularly sometimes have trouble with anesthesia. Is that true? I tried to find something on this but had trouble. Enjoyed

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