Department of Gastroenterology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Gastrointest Endosc. 2023 Oct;98(4):482-491. doi: 10.1016/j.gie.2023.05.056. Epub 2023 May 27.
This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach to strategies to prevent endoscopy-related injury (ERI) in GI endoscopists. It is accompanied by the article subtitled "Methodology and Review of Evidence," which provides a detailed account of the methodology used for the evidence review. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline estimates the rates, sites, and predictors of ERI. Additionally, it addresses the role of ergonomics training, microbreaks and macrobreaks, monitor and table positions, antifatigue mats, and use of ancillary devices in decreasing the risk of ERI. We recommend formal ergonomics education and neutral posture during the performance of endoscopy, achieved through adjustable monitor and optimal procedure table position, to reduce the risk of ERI. We suggest taking microbreaks and scheduled macrobreaks and using antifatigue mats during procedures to prevent ERI. We suggest the use of ancillary devices in those with risk factors predisposing them to ERI.
本临床实践指南由美国胃肠内镜学会制定,为预防胃肠内镜医师内镜相关损伤(ERI)提供了循证策略。它附有副标题为“方法学和证据回顾”的文章,详细介绍了证据审查所使用的方法。本文件采用推荐评估、制定与评估分级框架制定。指南估计了 ERI 的发生率、部位和预测因素。此外,它还探讨了人体工程学培训、微休息和宏休息、监视器和桌子位置、抗疲劳垫以及辅助设备在降低 ERI 风险中的作用。我们建议通过可调节的监视器和最佳的操作台面位置,实现正式的人体工程学教育和内镜操作时的中立姿势,以降低 ERI 的风险。我们建议在操作过程中采取微休息和预定的宏休息,并使用抗疲劳垫来预防 ERI。我们建议有 ERI 风险因素的患者使用辅助设备。