1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
2Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
3Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
4Institute for Digestive Research, Soonchunhyang University Seoul Hospital, Seoul, Korea
5Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
6Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
Copyright © 2021 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest: The authors have no potential conflicts of interest.
Funding
None.
Author Contributions
Conceptualization: The Committees of Quality Management and Conscious Sedation of Korean Society of Gastrointestinal Endoscopy (KSGE)
Data curation: Jun Kyu Lee, Jung-Wook Kim, Tae Hee Lee, Jae-Yong Jang, Byung-Wook Kim
Formal analysis: JKL, Seon-Young Park
Investigation: KSGE
Project administration: Byung Ik Jang, Chang-Hwan Park
Supervision: BIJ, CHP
Validation: KSGE
Writing-original draft: SYP, JKL
Writing-review&editing: SYP, JKL, CHP
Number of endoscopists affiliated with the Subspecialty Board of Gastrointestinal Endoscopy by KSGE, no. (mean±SD, range) | 10.2±5.2 (3-34) |
Regulations regarding sedation training for working personnel*, no. (%) | 50 (100.0) |
Completion of education programs by working personnel, no. (%) | 50 (100.0) |
The source of education program**, no. (%) | |
Education program for propofol sedation endorsed by the KMA | 4 (8.0) |
Seminars or workshops provided by the KSGE | 23 (46.0) |
Training sessions approved by the KNA/the KSGNA | 24 (48.0) |
Education programs of each endoscopic unit | 31 (62.0) |
KMA, Korean Medical Association; KNA, Korean Nurses Association; KSGE, Korean Society of Gastrointestinal Endoscopy; KSGNA, Korean Society of Gastrointestinal Endoscopy Nurses and Associates; SD, standard deviation.
*Endoscopists and nursing personnel including registered nurses (RNs), nursing assistants, and assistants.
**Multiple answers possible.
Number of monitoring personnel present during an examination, no. (%) | |
1 member of the nursing personnel | 35 (70.0) |
2 or more members of the nursing personnel | 12 (24.0) |
Another doctor | 3 (6.0%) |
Equipment with oxygen supply and suction systems, no. (%) | 50 (100.0) |
Oxygen supply, no. (%) | |
In case of hypoxia | 50 (100.0) |
Routine supply before administration of sedatives | 32 (64.0) |
Monitoring equipment* at each bed in the examination room, no. (%) | 40 (80.0) |
Regular measurement of vital signs | |
Oxygen saturation | 50 (100.0)** |
Blood pressure | 50 (100.0) |
>75% of patients | 37 (74.0) |
50–75% of patients | 2 (4.0) |
25–50% of patients | 2 (4.0) |
<25% of patients | 9 (18.0) |
Electrocardiography | 50 (100.0) |
>75% of patients | 23 (46.0) |
50–75% of patients | 0 (0.0) |
25–50% of patients | 3 (6.0) |
<25% of patients | 24 (48.0) |
Level of consciousness | 50 (100.0) |
>75% of patients | 44 (88.0) |
50–75% of patients | 2 (4.0) |
25–50% of patients | 1 (2.0) |
<25% of patients | 3 (6.0) |
Decision of sedatives, initial dose, and additional dosing interval, no. (%) | |
Endoscopist | 47 (94.0) |
Another doctor | 1 (2.0) |
Anesthesiologist | 1 (2.0) |
Trained nurse | 1 (2.0) |
Type of sedatives*, no. (%) | |
Midazolam | 18 (36.0) |
Propofol, single | 11 (22.0) |
Propofol, balanced with midazolam | 27 (54.0) |
Other | 1 (2.0) |
Availability of antidotes in the examination room, no. (%) | 50 (100.0) |
Indication of antidotes*, no. (%) | |
Hypoxia | 39 (78.0) |
Paradoxical response | 34 (68.0) |
Routine use | 5 (10.0) |
Other | 1 (2.0) |
Management of paradoxical response*, no. (%) | |
Non-sedated exam with use of antidotes | 48 (96.0) |
Additional dosing with another sedative | 39 (78.0) |
Additional dosing with the same sedative | 5 (10.0) |
Other | 2 (4.0) |
Equipment for cardiopulmonary resuscitation, no. (%) | 49 (98.0) |
Keeping records of adverse events related to sedation, no. (%) | 37 (74.0) |
Number of endoscopists affiliated with the Subspecialty Board of Gastrointestinal Endoscopy by KSGE, no. (mean±SD, range) | 10.2±5.2 (3-34) |
Regulations regarding sedation training for working personnel |
50 (100.0) |
Completion of education programs by working personnel, no. (%) | 50 (100.0) |
The source of education program |
|
Education program for propofol sedation endorsed by the KMA | 4 (8.0) |
Seminars or workshops provided by the KSGE | 23 (46.0) |
Training sessions approved by the KNA/the KSGNA | 24 (48.0) |
Education programs of each endoscopic unit | 31 (62.0) |
ASA Physical Status Classification scores, no. (%) | 41 (82.0) |
>75% of patients | 37 (91.3) |
50–75% of patients | 0 (0) |
25–50% of patients | 0 (0) |
<25% of patients | 4 (8.7) |
Mallampati score, no. (%) | 34 (68.0) |
>75% of patients | 18 (52.9) |
50–75% of patients | 1 (3.6) |
25–50% of patients | 1 (3.6) |
<25% of patients | 14 (41.1) |
Number of monitoring personnel present during an examination, no. (%) | |
1 member of the nursing personnel | 35 (70.0) |
2 or more members of the nursing personnel | 12 (24.0) |
Another doctor | 3 (6.0%) |
Equipment with oxygen supply and suction systems, no. (%) | 50 (100.0) |
Oxygen supply, no. (%) | |
In case of hypoxia | 50 (100.0) |
Routine supply before administration of sedatives | 32 (64.0) |
Monitoring equipment |
40 (80.0) |
Regular measurement of vital signs | |
Oxygen saturation | 50 (100.0) |
Blood pressure | 50 (100.0) |
>75% of patients | 37 (74.0) |
50–75% of patients | 2 (4.0) |
25–50% of patients | 2 (4.0) |
<25% of patients | 9 (18.0) |
Electrocardiography | 50 (100.0) |
>75% of patients | 23 (46.0) |
50–75% of patients | 0 (0.0) |
25–50% of patients | 3 (6.0) |
<25% of patients | 24 (48.0) |
Level of consciousness | 50 (100.0) |
>75% of patients | 44 (88.0) |
50–75% of patients | 2 (4.0) |
25–50% of patients | 1 (2.0) |
<25% of patients | 3 (6.0) |
Decision of sedatives, initial dose, and additional dosing interval, no. (%) | |
Endoscopist | 47 (94.0) |
Another doctor | 1 (2.0) |
Anesthesiologist | 1 (2.0) |
Trained nurse | 1 (2.0) |
Type of sedatives |
|
Midazolam | 18 (36.0) |
Propofol, single | 11 (22.0) |
Propofol, balanced with midazolam | 27 (54.0) |
Other | 1 (2.0) |
Availability of antidotes in the examination room, no. (%) | 50 (100.0) |
Indication of antidotes |
|
Hypoxia | 39 (78.0) |
Paradoxical response | 34 (68.0) |
Routine use | 5 (10.0) |
Other | 1 (2.0) |
Management of paradoxical response |
|
Non-sedated exam with use of antidotes | 48 (96.0) |
Additional dosing with another sedative | 39 (78.0) |
Additional dosing with the same sedative | 5 (10.0) |
Other | 2 (4.0) |
Equipment for cardiopulmonary resuscitation, no. (%) | 49 (98.0) |
Keeping records of adverse events related to sedation, no. (%) | 37 (74.0) |
Size of recovery rooms, m2, mean ± SD (range) | 67.8±48.7 (6.5-240) |
Number of beds in recovery rooms, mean ± SD (range) | 13.8±6.7 (3-35) |
Number of beds in recovery rooms/number of patients, no. (%) | |
<1/10 | 33 (66.0) |
1/10–1/15 | 9 (18) |
1/15–1/30 | 4 (8.0) |
>1/30 | 4 (8.0) |
Equipment with portable oxygen tanks for emergency, no. (%) | 47 (94.0) |
Specific assignment of nursing personnel for recovery rooms | 47 (94.0) |
Number of nursing personnel, mean ± SD (range) | 1.5±0.5 (1-6) |
Number of nursing personnel in recovery rooms/number of patients, no. (%) | |
<1/10 | 24 (48.0) |
1/10–1/15 | 12 (24.0) |
1/15–1/30 | 10 (20.0) |
>1/30 | 4 (8.0%) |
Fulfilling the discharge criteria | 50 (100.0) |
Recommendation for an outpatient to be accompanied by a guardian | 50 (100.0) |
KMA, Korean Medical Association; KNA, Korean Nurses Association; KSGE, Korean Society of Gastrointestinal Endoscopy; KSGNA, Korean Society of Gastrointestinal Endoscopy Nurses and Associates; SD, standard deviation. Endoscopists and nursing personnel including registered nurses (RNs), nursing assistants, and assistants. Multiple answers possible.
ASA, American Society of Anesthesiologists.
includes electrocardiography, blood pressure, and oxygen saturation. continuous monitoring for every patient.
Multiple answers possible
SD, standard deviation.