Gastroscopy with only throat spray ‘sedation’ + anxiety pill

Grandmafrench

Blossoming

Marydoll

It is nothing to do with heroics. For some of us, GA or sedation is deemed too risky by our clinicians.

Same for me Marydoll. It isn’t pleasant but I have no option.

But, unless that includes the Original Poster, that's not an entirely helpful response.

Neither was the comment about heoics.

Marydoll

Grandmafrench

Blossoming

Marydoll

It is nothing to do with heroics. For some of us, GA or sedation is deemed too risky by our clinicians.

Same for me Marydoll. It isn’t pleasant but I have no option.

But, unless that includes the Original Poster, that's not an entirely helpful response.

Neither was the comment about heoics.

Or even heroics. 😊

Farzanah

Well done for persevering HooteNanny.
It doesn’t seem very satisfactory to me to put patients on a conveyor belt of “4 an hour”. Not everyone will cope with the procedure and so there may be a few wasted appointments it strikes me. I think everyone should be offered the choice of sedation if they want.

I think 18 months wait is unacceptable, depending on symptoms. When you receive an appt let them know you are happy to take a cancellation. I would also check if there are other NHS centres with shorter waiting lists that you can be referred to.

Farzanah, I'm afraid 4 gastroscopies an hour is standard in any endoscopy department.

The Bristish Society of Gastroenterologists (BSG) recommend 15-20 minutes per procedure. That includes patient coming into the room, safety checks done, a quick chat with the patient (consultoscopy!) administration of throat spray or sedation, procedure completed and report written.

You are correct that some patients take longer, but some are quicker so it usually manages to balance out over a morning or afternoon list.

It is expected that I should be able to complete 10 patients every list. I am part time and only do 2-3 lists a week but my full time colleagues are expected to do 5 lists a week.

I work in an endoscopy department were we have 5 rooms working every day plus a 6th room for an additional 3 sessions a week. We diagnose/treat upwards of 80 patients a day over a variety of specialities/procedures (not just gastroscopy, which is one of the quickest procedures).

This is standard practice across all endoscopy departments whether it is NHS or separate diagnostic centres.

Dont forget you are the customer. You dont have to fit in with what these people say in a sheep like manner. I try to limit my interactions with doctors and hospitals. However I am quite able to advocate for myself and have refused several medical procedures in the last year.

I would threaten a formal complaint in your situation. I insisted upon sedation when I had an endosccopy and colonoscopy in the same session. However as I dont drive I was taking a taxi home and had my nephew with me. So there was no question of driving.

Of course you’re not a ‘wuss’! You’re rightly concerned that they won’t be able to complete the procedure if you can’t control your gagging reflex. Your needs should be assessed individually. You’re not wasting the NHS’s time to make sure you’ll be able to have the procedure.

There may be medical reasons why they prefer not to do the endoscopy under heavy sedation, if someone would explain it to you, it might help!

I hope you can speak to a doctor before you have the procedure.

SuperTinny

Farzanah

Well done for persevering HooteNanny.
It doesn’t seem very satisfactory to me to put patients on a conveyor belt of “4 an hour”. Not everyone will cope with the procedure and so there may be a few wasted appointments it strikes me. I think everyone should be offered the choice of sedation if they want.

I think 18 months wait is unacceptable, depending on symptoms. When you receive an appt let them know you are happy to take a cancellation. I would also check if there are other NHS centres with shorter waiting lists that you can be referred to.

Farzanah, I'm afraid 4 gastroscopies an hour is standard in any endoscopy department.

The Bristish Society of Gastroenterologists (BSG) recommend 15-20 minutes per procedure. That includes patient coming into the room, safety checks done, a quick chat with the patient (consultoscopy!) administration of throat spray or sedation, procedure completed and report written.

You are correct that some patients take longer, but some are quicker so it usually manages to balance out over a morning or afternoon list.

It is expected that I should be able to complete 10 patients every list. I am part time and only do 2-3 lists a week but my full time colleagues are expected to do 5 lists a week.

I work in an endoscopy department were we have 5 rooms working every day plus a 6th room for an additional 3 sessions a week. We diagnose/treat upwards of 80 patients a day over a variety of specialities/procedures (not just gastroscopy, which is one of the quickest procedures).

This is standard practice across all endoscopy departments whether it is NHS or separate diagnostic centres.

That’s interesting Super Tinny. That must be why I waited 2hrs for mine when my appt was 2pm and I was eventually called at 4pm, after having had no food or fluids all day and by which time BP was raised!
When they were unable to do my procedure I was given IV sedation before they continued, successfully. The procedure must have taken at least 30 minutes to complete.

Do you feel you have sufficient time to talk/reassure patients and administer IV into tricky veins in 15 mins?

Is transnasel when they stick the tube up your nose If so they tried that with me and I nearly hit the roof it felt like they were poking hard into my brain I pulled it out and told them I couldn’t tolerate it that’s when they suggested I needed sedation and then it was a breeze

I couldn't have the throat spray because I am allergic to bananas. Had mild sedation, the procedure was fibe

Farzanah

SuperTinny

Farzanah

Well done for persevering HooteNanny.
It doesn’t seem very satisfactory to me to put patients on a conveyor belt of “4 an hour”. Not everyone will cope with the procedure and so there may be a few wasted appointments it strikes me. I think everyone should be offered the choice of sedation if they want.

I think 18 months wait is unacceptable, depending on symptoms. When you receive an appt let them know you are happy to take a cancellation. I would also check if there are other NHS centres with shorter waiting lists that you can be referred to.

Farzanah, I'm afraid 4 gastroscopies an hour is standard in any endoscopy department.

The Bristish Society of Gastroenterologists (BSG) recommend 15-20 minutes per procedure. That includes patient coming into the room, safety checks done, a quick chat with the patient (consultoscopy!) administration of throat spray or sedation, procedure completed and report written.

You are correct that some patients take longer, but some are quicker so it usually manages to balance out over a morning or afternoon list.

It is expected that I should be able to complete 10 patients every list. I am part time and only do 2-3 lists a week but my full time colleagues are expected to do 5 lists a week.

I work in an endoscopy department were we have 5 rooms working every day plus a 6th room for an additional 3 sessions a week. We diagnose/treat upwards of 80 patients a day over a variety of specialities/procedures (not just gastroscopy, which is one of the quickest procedures).

This is standard practice across all endoscopy departments whether it is NHS or separate diagnostic centres.

That’s interesting Super Tinny. That must be why I waited 2hrs for mine when my appt was 2pm and I was eventually called at 4pm, after having had no food or fluids all day and by which time BP was raised!
When they were unable to do my procedure I was given IV sedation before they continued, successfully. The procedure must have taken at least 30 minutes to complete.

Do you feel you have sufficient time to talk/reassure patients and administer IV into tricky veins in 15 mins?

In answer to your question, no we don't always feel that enough time is given but like I mentioned for some it takes longer and others shorter so it does balance itself out.

To help manage our patients expectations our Patient Information Leaflets advise patients that they could be in the department for up to four hours and that their appointment time is not a reflection of their procedure time.

The admission process, consent and cannula insertion takes place prior to coming into the procedure room, and can sometimes take up to an hour. The 15-20 minute clock starts from when you enter the procedure room.

We also have to make time for emergencies that arise on the wards. This isn't, thank goodness, an everyday occurance.

There is no getting away from it, an endoscopy department is a process driven environment. It is a diagnostic service, designed to provide a 'diagnosis' or exclude something, in the same way you might have an Xray or a scan or have blood taken.

I'd say that with the problems you encountered you got away quite lightly with your time frame!

I've had two gastroscopys, both with throat spray and sedation, and knew nothing about it at all. A friend had it without sedation, and found it, naturally, very unpleasant.
I would insist on sedation if I were you.

Ah ha SuperTinny that is not how my hospital endoscopy department functions, and I can see why your time scale works.
I have subsequently had a barium swallow in the X-ray dept and it was a whole different experience because the staff were much kinder.

I am going to have an endoscopy in a few weeks and I have said that without sedation (i.e. being asleep!) I won't do it. Sorry, just no!