YKHC Low-Risk Endoscopy Criteria

OVERVIEW

Because YKHC has no ICU, serious endoscopy complications require transfer to the Emergency Department and/or Medevac transfer. Prevention of this occurrence is a priority. Therefore endoscopy in Bethel is limited to low risk patients.

The intention of this page is to provide transparent criteria for the most common comorbidities which increase the risk of an endoscopy complication. This page is not all-inclusive.

These criteria are written with isolated diagnoses in mind. The presence of multiple comorbidities may yield a higher risk than either individually and this effect is not incorporated into these criteria.

The intention of these criteria is to risk stratify based on the functional status of a disease rather than its mere mention in a patient's chart.

GENERAL

BMI

• BMI < 45 (non-negotiable limit)
• For BMI 40-45, consult anesthesia; the decision will likely hinge upon the absence or presence of comorbidities.

CARDIAC

CHF

1. Most recent LVEF >= 40%
2. Recent (<6mos) BNP <= 125 pg/mL (or YKHC laboratory’s current upper limit of normal)
3. No loop diuretic use (chronic or acute) within the last 12 months

CAD

1. No history of coronary revascularization (either surgical or endovascular)
2. No use of anti-angina agents in the last 12 months
3. Normal cardiac stress test within the last 12 months

A-Fib

1. Currently in sinus rythm
2. No subjective or objective A-Fib occurrence within 12 months
3. No use of anti-arrythmic drugs within 12 months
4. Meets all of the "CHF" criteria above

PULMONARY

COPD

• Post-bronchodilator FEV₁ >= 60% of predicted
  • order as "PFT(Pre-&Post-Albuterol)Eval"

OSA

• Positive pressure ventilation has NOT been recommended/prescribed

MEDICATIONS

Antiplatelets

• _

Anticoagulants

• _

Opioid Replacement Therapy

• _