Douglass, A.; Bramble, M.G.; Barrison, I.G.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA113
Academic Journal
Introduction: Upper gastrointestinal bleeding (UGIB) carries a significant mortality. Emergency endoscopy, with the potential for therapeutic gain should be available in all large hospitals for such patients. Staff and facilities are important aspects in the management of Gl haemorrhage but there is no national data on how such services are planned and funded. Clinical governance should ensure that all hospital admitting patients with Gl bleeding have adequate systems in place to offer an effective emergency endoscopy service. Aims and Objectives: To assess nationally the current level of for emergency endoscopic provision in JAG registered training units. Methods: A questionnaire based on the BSG working party report (2001) on the provision of endoscopy related procedures, was distributed to all JAG registered units between 2001 and 2002. Data were entered into a standard statistical package for analysis. Results: 150 (76.5%) of units returned a completed questionnaire. 111 units performed an average of 91.2 ± 8.1 (per 100 000 population) emergency endoscopies per year. 29.6% were performed out of hours. The on call rota was formal in 64.6%, "ad hoc" in 31.9% and not present in the remainder. There were 4.6 +/- 0.2 consultants on the rota, only 8% of who received recognition of their work, in their contract. In 34.7% of centres juniors were regularly involved in the on call rota and acted independently in 12.9% Emergency endoscopies were carried out in: the endoscopy unit 56%, theatre 37%, admission unit 7%, and were staffed by endoscopy nurses in only 45% ward or theatre staff in the remaining cases). Additional sessions were provided throughout the normal week" in 32% of units, 50% of which were before 9.00 am. Conclusions: One third of JAG registered units have unsatisfactory arrangements for managing acute Gl bleeding. In a further third, surgical theatres are used to perform examinations. Trusts must work towards implementing the working party...


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