Endoscopy unit
Encyclopedia
An endoscopy unit refers to a dedicated area where medical procedures are performed with endoscopes, which are cameras used to visualize structures within the body, such as the digestive tract and genitourinary system
. Endoscopy units may be located within a hospital
, incorporated within other medical care centres, or may be stand-alone in nature.
In the early days of endoscopy, when fewer procedures were carried out, facilities such as operating theatres tended to be used; as the number of procedures carried out and the complexity of the procedures and equipment increased, the need for specialised rooms and staff became apparent.
, ERCP
, and endoscopic ultrasound
), bronchoscopy
, cystoscopy
, or other more specialized procedures. Endoscopy units may be part of a hospital, where emergency procedures may be performed on ill patients admitted to hospital; however, most endoscopies are performed on ambulatory patients in the outpatient setting.
Procedure rooms should to contain:
Procedure rooms should be at least 200 square feet (18.6 m²) in size, and hospitals should have at least two procedure rooms. Larger endoscopy units should contain one procedure room per 1,000 to 1,500 procedures performed annually.
and emergency drugs.
Genitourinary system
In anatomy, the genitourinary system or urogenital system is the organ system of the reproductive organs and the urinary system. These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathways, like the male urethra...
. Endoscopy units may be located within a hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
, incorporated within other medical care centres, or may be stand-alone in nature.
In the early days of endoscopy, when fewer procedures were carried out, facilities such as operating theatres tended to be used; as the number of procedures carried out and the complexity of the procedures and equipment increased, the need for specialised rooms and staff became apparent.
Components
An endoscopy unit consists of the following components: trained and accredited endoscopists (which are usually gastroenterologists or surgeons); trained nursing and additional staff; endoscopes and other equipment; preparation, procedural and recovery areas; a disinfection and cleaning area for equipment; emergency equipment and personnel; and, a program for quality assurance. Procedures performed within an endoscopy unit may include gastrointestinal endoscopy (such as gastroscopy, colonoscopyColonoscopy
Colonoscopy is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis and grants the opportunity for biopsy or removal of suspected...
, ERCP
Endoscopic retrograde cholangiopancreatography
Endoscopic retrograde cholangiopancreatography is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems...
, and endoscopic ultrasound
Endoscopic ultrasound
Endoscopic ultrasound or echo-endoscopy is a medical procedure in endoscopy is combined with ultrasound to obtain images of the internal organs in the chest and abdomen. It can be used to visualize the wall of these organs, or to look at adjacent structures...
), bronchoscopy
Bronchoscopy
Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for...
, cystoscopy
Cystoscopy
Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope.Diagnostic cystoscopy is usually carried out with local anaesthesia...
, or other more specialized procedures. Endoscopy units may be part of a hospital, where emergency procedures may be performed on ill patients admitted to hospital; however, most endoscopies are performed on ambulatory patients in the outpatient setting.
Layout
Endoscopy units consist of a number of areas:- Reception and waiting area for patients and relatives.
- Consultation rooms.
- Changing areas.
- Procedure rooms.
- Recovery area.
- Decontamination area.
Procedure rooms
These are the rooms where the endoscopic procedures are performed.Procedure rooms should to contain:
- Patient trolley.
- Endoscopy 'stack' and video monitor(s) – this equipment contains the light source and processor required for the endoscopes to produce images.
- Monitoring equipmentMedical monitorA medical monitor or physiological monitor or display, is an electronic medical device used in medical monitoring that displays the monitored data, and may or may not have the ability to transmit the data on a monitoring network...
to allow continuous monitoring of patient condition during procedures. - suction equipmentAspirator (medical device)A medical aspirator is a small suction machine used to remove mucus and other bodily fluids from a patient. These machines are often designed to be portable for use in ambulances and nursing homes, and can run on AC/DC or battery power. Major manufacturers include Allied Healthcare and Impact...
to allow both aspiration of airwayAirwayThe pulmonary airway comprises those parts of the respiratory system through which air flows, conceptually beginning at the nose and mouth, and terminating in the alveoli...
secretions and to allow aspiration of fluid through the endoscope. - Piped oxygen supply.
- Medication used to provide procedural sedationProcedural sedationProcedural sedation and analgesia previously referred to as conscious sedation is defined as "a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory...
. - Ancillary equipment - endoscopy biopsy forceps, snares, injectors (see Instruments used in gastroenterologyInstruments used in gastroenterologyInstruments used specially in Gastroenterology are as follows:__Forcetoc__- Instrument list :...
). - Diathermy and/or Argon plasma coagulationArgon plasma coagulationArgon plasma coagulation or APC is a medical endoscopic procedure used primarily to control bleeding from certain lesions in the gastrointestinal tract, and also sometimes to debulk tumours in the case of patients for whom surgery is not recommended...
equipment. - Computer(s) used to generate endoscopy reports.
Procedure rooms should be at least 200 square feet (18.6 m²) in size, and hospitals should have at least two procedure rooms. Larger endoscopy units should contain one procedure room per 1,000 to 1,500 procedures performed annually.
Recovery area
Since a number of patients undergoing endoscopy receive sedation, and a few emergency patients may be unstable, there must be an area available for the observation of patients until they have recovered. These areas also need to have piped oxygen, full monitoring facilities (including pulse oximetry), suction, resuscitation equipmentCardiopulmonary resuscitation
Cardiopulmonary resuscitation is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive...
and emergency drugs.