Emergency upper gastrointestinal endoscopy in the Emergency Room of Tokai University Hospital.

The Tokai University Hospital is the only tertiary emergency hospital in the western region of Kanagawa prefecture and treats many patients; for example, more than 7,000 cases (including 297 helicopter-transfer cases) were transferred to the Emergency Room (ER) of the hospital in 2008. In cases where an emergency endoscopy is necessary, such as suspected upper gastrointestinal (UGI) tract bleeding, the gastroenterologists and the ER staff collaborate on patient care, diagnosis and treatment. The purpose of this study was to summarize such cases in the hospital and to elucidate the possible problems that such collaboration may cause, by means of a questionnaire completed by both the gastroenterology and the ER staff. There were 366 emergency upper GI endoscopies performed in the ER from April 2007 to October 2009, which included 163 hemostasis, 8 foreign body retrievals and 195 observation-only cases. After arrival of the patients, first the ER staff took care of them, then the gastroenterologist was called and both collaborated on the procedures to be implemented. The questionnaires revealed that, generally speaking, the collaboration worked well, but there were several problems that needed to be solved including maintenance, equipment supply and assistance of therapeutic endoscopy.