Direct referral of a patient for gastroscopy or colonoscopy can be made without a formal consultation by a gastrointestinal endoscopist in advance.
Open access endoscopy is not suitable for all patients, particularly those with significant co-morbidities which might impact on pre-procedure advice, peri-procedure medication management, or even the most appropriate setting for the procedure.
Patients who fall into this category include:
Patients with significant cardiac disease (e.g. severe aortic stenosis, mechanical valve replacement, pulmonary hypertension, decompensated cardiac failure, or poorly controlled ischaemic heart disease).
Significant airway’s disease.
Severe obstructive sleep apnoea.
Poorly controlled insulin dependent diabetes
Special consideration may need to be given to:
Morbidly obese patients (BMI>45 Kg/m2)
Patients on warfarin or other anti-coagulant therapy
Any elderly patient with significant frailty, particularly nursing home patients or patients with significant mobility issues
A patient’s social circumstances, for example an elderly patient living alone may not be suitable to take colonoscopy bowel preparation without adequate supervision due to the risk of falls
Wollongong Day Surgery has protocols in place to screen open access endoscopy patients when they first contact us for an appointment. This includes over the phone or face-to-face screening questions and also review of health information forms.
If indicated, certain patients may undergo a pre-procedure consultation with their Endoscopist or Anaesthetist to ensure optimisation of their care prior to the procedure or that the procedure is performed in an appropriate setting.
If you are unsure about the suitability of a patient for open access endoscopy, then please refer the patient to one of our Endoscopists for a consultation.