Endoscopy in the ED

Recommendations: EGD sedation for GIB

1. Deep sedation/propofol should not be used for any EGD.

2. Ideally, the procedure should be been done in the ICU or endoscopy suite

3. When deep sedation or general anesthesia for EGD is required, an anesthesiologist should perform the procedure in the OR. (This really should not be done with deep sedation by anyone)

4 There is always an OR that can be made available. If the patients is too unstable to wait, they should have their airway controlled anyway and then you don't need any type of procedural sedation.

5. If patient needs to be intubated in the ED for other reasons, then EGD can be done in the ED if an ICU bed is not available.

Emergency Department Recommendations: EGD sedation and foreign body removal

1. Deep sedation/propofol/etomidate/ketamine should not be used for any EGD

2. Moderate sedation i.e. fentanyl and versed can be used

3. Generally, GI should bring these patients to the OR.

Please refer to the attached file below about the policy on the timing and location of EGDs.